Case Report Bilateral Diabetic Knee Neuroarthropathy in a Forty-Year-Old Patient Patrick Goetti, Nicolas Gallusser, and Olivier Borens Department of Orthopedics and Traumatology, Lausanne University Hospital, rue du Bugnon 46, 1011 Lausanne, Switzerland Correspondence should be addressed to Patrick Goetti; patrick.goetti@chuv.ch Received 18 June 2016; Accepted 22 August 2016 Academic Editor: Bayram Unver Copyright © 2016 Patrick Goetti et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Diabetic osteoarthropathy is a rare cause of neuropathic joint disease of the knee; bilateral involvement is even more exceptional. Diagnosis is ofen made late due to its unspecifc symptoms and appropriate surgical management still needs to be defned, due to lack of evidence because of the disease’s low incidence. We report the case of a forty-year-old woman with history of diabetes type I who developed bilateral destructive Charcot knee arthropathy. Bilateral total knee arthroplasty was performed in order to achieve maximal functional outcome. Follow-up was marked by bilateral tibial periprosthetic fractures treated by osteosynthesis with a satisfactory outcome. Te diagnosis of Charcot arthropathy should always be in mind when dealing with atraumatic joint destruction in diabetic patients. Arthroplasty should be considered as an alternative to arthrodesis in bilateral involvement in young patients. 1. Introduction Te frst anatomopathological description of neuropathic joint destruction was reported by Jean-Martin Charcot in 1868. While many disorders have been related to neuropathic joint arthropathy, diabetes mellitus is nowadays the primary etiology [1–4]. Te prevalence of diabetic osteoarthropathy lies between 0.1 and 13% [5]. Bilateral Charcot arthropathy is a rare condition [6]. Te diagnosis is ofen made late due to the unspecifc early presentation of brutal infammatory joint pain, which can also be misdiagnosed as common fracture, infectious, rheumatic arthritis, deep venous throm- bosis, algoneurodystrophy, or erysipelas [7]. Te diagnosis is made with standard X-rays and infammatory parameters on blood tests. Due to its low incidence, the appropriate surgical treatment is still controversial with a trend going towards total knee arthroplasty (TKA). 2. Case Presentation A forty-year-old woman with history of type I diabetes mellitus complicated with diabetic neuropathy and Char- cot disease of her right foot is referred from her general practitioner with right knee pain without history of trauma. Te initial X-rays revealed a Schatzker type V tibial plateau fracture which was surgically treated by open reduction and lateral plate osteosynthesis using a locking compression plate (LCP) (Figures 1, 2, and 3). Progressive secondary fracture displacement on follow-up X-rays associated with necrosis of the medial tibial plateau and fnally plate failure at three months postoperatively was observed (Figure 4). Varus pseudolaxity was present on clinical examination, a low-grade infection was suspected, and removal of hardware and wide debridement were performed. A postoperative CT- scan showed complete articular destruction of the medial and lateral tibial plateau (Figure 5). Sonication of the implant and standard microbiological exams remained negative. Due to the important destruction of the proximal tibia, a cemented rotating hinged knee prosthesis (RHK, Zimmer5) was implanted. Postoperatively the patient stayed for six weeks with partial weight bearing. Knee range of motion (ROM) was 105/0/0 ∘ (fexion/extension/hyperextension) at nine days postoperatively. Wound healing was uneventful in a satisfed patient with no complaints about her knee. Eighteen months afer initial management of the right knee, the patient presented at our outpatients’ clinic with complaints of progressive invalidating contralateral knee pain. Performing the X-rays of the lef knee, we were Hindawi Publishing Corporation Case Reports in Orthopedics Volume 2016, Article ID 3204813, 4 pages http://dx.doi.org/10.1155/2016/3204813