This 65 yr old lady came from Oman to MIOT because of arthritis and pain in the right knee and difficulty in walking due to her right knee bending outwards when she stood.

On examination she was a diabetic, she had morbid obesity, she weighed 160 kilos and was able to stand only with support but with difficulty.

We decided to do a special hinge knee replacement for her because a normal knee replacement would fail. The hinged knee was implanted with long stems and metaphyseal sleeves which were fixed together at the knee joint by a hinge so they would not be subjected to outward bending forces.

The post-operative x-ray showed excellent alignment of the knees and she was able to walk very well.

We discharged her with advice to reduce weight by diet and subsequently after going home, she lost weight and was able to walk pain free.

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