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Case Spotlight: Managing Advanced Bilateral Lower Limb Lymphedema and Knee Osteoarthritis in a 75-Year-Old Patient
A 75-year-old woman presented to our clinic with significant mobility limitations. She has been living with bilateral lower limb lymphedema for over 30 years, secondary to chronic filariasis, and has become wheelchair-dependent due to severe knee osteoarthritis.Over the past two decades, she had gradually lost the ability to ambulate independently, relying on a walker for minimal movement. The persistent swelling, heaviness, and tightness in both legs had affected her quality of life considerably.
Around 2.5 years ago, she was treated at our clinic with platelet-rich plasma (PRP) and hyaluronic acid intra-articular injections, along with cooled radiofrequency ablation (RFA). This regenerative and neuroablative therapy offered substantial pain relief for over two years—a remarkable outcome given her complex condition.
Filariasis with progressive Lymphoedema, causing severe difficulty in mobilising. Severe pains due to Osteoarthritis.
Given the clinical scenario, we opted for a repeat image-guided injection with PRP and hyaluronic acid, this time performed under fluoroscopic and ultrasound guidance to ensure precision and maximum therapeutic effect.
This case highlights the unique challenges of managing chronic infectious lymphedema coexisting with degenerative joint disease in the elderly. When total knee replacement surgery is not an option, minimally invasive, image-guided regenerative therapies and neuroablative procedures offer a viable path to reduce pain and improve quality of life.
At our clinic, we remain committed to using innovative, patient-centered approaches to address even the most complex cases.
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