Total knee arthroplasty following fractures around the knee

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Leandro Ariel Salcedo Zunino
Natalia Gutierrez Olivera
Ignacio Pioli
Fernando Bidolegui
Gabriel Vindver
Bartolome Luis Allende

Abstract

IntroductionSurgical treatment for posttraumatic arthritis secondary to distal femur or proximal tibia periarticular fractures is uncommon and complex. Total knee arthroplasty (TKA) is a valid option. Objectives: functional and radiological review of TKA after post traumatic arthritis.MethodsRetrospective review. 29 patients who underwent TKA for posttraumatic arthritis between 2008–2015. 19 female, 10 male. Average age: 59 years. 23 secondary to proximal tibial fracture and 6 to distal femur; 6 extraarticular fractures and 23 intraarticular. Initial treatment was non-surgical in 8 patients, open reduction and internal fixation was performed in 21. Surgeries before arthroplasty 2.14 (1–7). Patients were followed with the Knee Society Score (KSS) as well as radiological assessment. Preoperative range of motion was: flexion 60º (45 – 90) and extension 15º (0 – 90). Pain KSS 30 (10-45), functional KSS 25 (20-45). Total KSS 81 (50-60).ResultsFollow up 30 months (12 – 50). ROM improved flexion 95º (60 –120) and extension 5º (0 – 30). KSS for pain 40 (30 – 50) and functional KSS 35 (30 – 50). Total KSS 80 (50 – 95). Results were good (KSS ≥ 80 points) in 22 patients (75,8%), regular in 6 (20,6%), poor in 1 case (3,44%). Mechanical axis was restored in all cases. 13 % of mayor complications.ConclusionsTKA after posttraumatic arthritis is a technically demanding surgery. Required a detailed preoperative planning, surgical skills, implant systems and solutions reserve for revision arthroplasty, carefully soft tissue management. Although complications rate is higher than TKA for the treatment of primary knee osteoarthritis, it is a good procedure for complex reconstructions, relieves pain and improves patient functional outcomes.

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How to Cite
Salcedo Zunino, L. A., Gutierrez Olivera, N., Pioli, I., Bidolegui, F., Vindver, G., & Allende, B. L. (2017). Total knee arthroplasty following fractures around the knee. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 82(2), 102-108. https://doi.org/10.15417/551
Section
Clinical Research

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