Artroplastia total de rodilla en pacientes con secuela de fracturas articulares. Resultados del seguimiento a mediano plazo

  • Harold Simesen de Bielke Servicio de Ortopedia y Traumatología, Sanatorio Modelo de San Miguel de Tucumán, Tucumán, Argentina
  • Leonel Pérez Alamino Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
  • Santiago Aguer Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
  • Germán Garabano Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
  • Hernán del Sel Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
  • Fernando Lopreite Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Abstract

Introduction: Knee joint fractures are common in Orthopedics, and may evolve to post-traumatic Osteoarthritis (PTOA). Total Knee Arthroplasty (TKA) is an effective treatment for the end-stage of this process. When indicated, orthopedic surgeons face many situations that may cause unsatisfactory results and affect prosthesis survival. The purpose of our study was to evaluate TKA outcomes on Osteoarthritis secondary to distal femoral and proximal tibial joint fractures, in cases with a minimum follow-up period of 4 years. Materials and Methods: We carried out an observational, retrospective study on TKA patients treated between May 1999 and January 2013. We evaluated 25 TKAs, performed on 24 patients, with knee fracture sequela, with an average follow-up of 6.1 years and an average age of 67.1 years. Three cases (12%) had required additional surgeries before TKA. Eight cases (32%) were 2-stage surgeries. Constrained implants were used in four cases (16%). The Knee Society Score (KSS), the Functional KSS (KSSf) and the Range of Motion (ROM) were evaluated preoperatively and at the last follow-up. Prosthesis survival evaluation was documented. Results: KSS increased from a preoperative average of 38.5 to a postoperative average of 82.8. Postoperative KSSf increased on average from 48 to 85. ROM increased on average from 7.5°-76° to 1°-102.4°. Four patients required a second surgical procedure. Prosthesis survival was 92% at a 6.1-year average follow-up. Conclusion: TKA is an appropriate treatment for advanced PTOA, with good mid-term outcomes. If adequate postoperative alignment and correct component positioning is achieved, expected outcomes are satisfactory and similar to those with TKA in primary osteoarthritis.

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Published
2020-10-07
How to Cite
Simesen de Bielke, H., Pérez Alamino, L., Aguer, S., Garabano, G., del Sel, H., & Lopreite, F. (2020). Artroplastia total de rodilla en pacientes con secuela de fracturas articulares. Resultados del seguimiento a mediano plazo . Revista De La Asociación Argentina De Ortopedia Y Traumatología, 85(2). Retrieved from https://raaot.org.ar/index.php/AAOTMAG/article/view/1268
Issue
Vol 85 No 2 (2020)
Section
Clinical Research

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