Primary total knee arthroplasty in the management of epiphyseal fracture around the knee

Parratte, Sébastien; Bonnevialle, P.; Piétu, G.; Saragaglia, D.; Cherrier, B.; Lafosse, J.-M.

doi:10.1016/j.otsr.2011.06.008

Cited by 52 publications

(74 citation statements)

References 29 publications

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“…The same bias of including distal femoral fractures was noted in another study. 29 Comparable results were published by Vermeire and Scheerlinck 6 and Haufe et al 28 Vermeire and Scheerlinck 6 reported an average KSS of 78 (range, 50-100), function score of 58 (range, 0-100), and excellent results in 7/12 (58%) in 12 patients. They claimed that the fair and poor results (four patients) were related to the poor general condition of those patients not to the procedure.…”

Section: Discussionmentioning

confidence: 58%

“…Other authors highlighted similar conclusions recommending primary TKA for acute geriatric tibial plateau fractures. 6,[28][29][30][31][32][33] The length of hospital stay (LOS) was similar in both groups averaging 12.5 days in TKA patients and 10.4 days in ORIF patients. This is mainly because of the emergency nature of the procedure and the associated comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Other authors highlighted similar conclusions recommending primary TKA for acute geriatric tibial plateau fractures. 6,[28][29][30][31][32][33] Traditionally, patients with complex displaced intra-articular fractures of the tibial plateau are typical candidates for ORIF or external fixation using different frame varieties. [38][39][40] Further solutions including adjoining baloon tibiolplasty were proposed to overcome the challenges found with fixation when osteoporosis was added to the problem.…”

Section: Discussionmentioning

confidence: 99%

“…Another multicentric French study evaluated the outcomes of TKA for distal, femoral, and proximal tibial fractures; they included 23 patients in total. 29 The authors suggested primary TKA as an efficient option for managing intra-articular distal femoral or intra-articular proximal tibial fractures in elderly patients with severe osteopenia and OA. Nevertheless, the inclusion criteria of that study are a source of bias for their results.…”

Section: Discussionmentioning

confidence: 99%

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Primary Total knee Arthroplasty: A Viable Surgical Option for Complex Tibial Plateau Fractures in Elderly

2019

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The optimal treatment of complex tibial plateau fractures in elderly is still controversial. The aim of the study was to retrospectively analyze the clinical and radiological outcomes of primary total knee arthroplasty (TKA) versus open reduction and internal fixation (ORIF) in elderly patients presenting with acute complex tibial plateau fractures. Between June 2011 and December 2015, we have analyzed the clinical outcomes of 22 primary total knee replacements and 21 ORIFs. The mean follow-up was 27 months. The intra- and postoperative complications, as well as the knee society score (KSS), were our outcome measures. The knee range of motion and the KSS knee and function scores were significantly better in the TKA patients compared with ORIF patients. Early postoperative full weight-bearing was allowed in the TKA patients with lower complications rate. In conclusion, primary TKA utilizing a stemmed tibial component is an effective treatment option for elderly patients with a complex acute fracture of the tibial plateau. This is a Type III therapeutic study.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Primary Total knee Arthroplasty: A Viable Surgical Option for Complex Tibial Plateau Fractures in Elderly

2019

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“…The authors described 23 % of immediate general complications and 15 % of local knee-related complications. With these data they concluded that TKA is a suitable option for complex distal femoral or proximal tibial fracture in elderly patients, but the complication rate is higher compared to elective TKA and comparable to TKA in post-traumatic arthritis [ 14 ].…”

Section: Resultsmentioning

confidence: 97%

Primary Total Knee Arthroplasty (TKA) in Tibial Plateau Fractures

Rosso

Blonna

Marmotti

et al. 2016

Fracture Management Joint by Joint

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Fifty percent of tibial plateau fractures occur in adult older than 50 years old, with 8-24 % of those occurring in elderly patients. The gold standard treatment for these fractures in young patients is open reduction and internal fi xation (ORIF). However, because of poor bone quality, soft tissue impairment, and complications related to immobilization, ORIF in the elderly are associated to a high complication rate. For this reason, some authors proposed early total knee arthroplasty (TKA) to treat tibial plateau fractures in elderly patients affected by prior osteoarthritis. Surgeons approaching this surgery should be aware that the outcomes are inferior compared to elective TKA. Furthermore, the complication rate following TKA in tibial plateau fractures are more similar to revision TKA than primary TKA. For these reasons, early arthroplasty in proximal tibial fractures should be reserved to elderly patients affected by prior osteoarthritis, who do not comply with the restricted weight-bearing postoperative protocol in order to avoid further surgery. There are few reports on literature reporting on the outcomes of early TKA in tibial plateau fractures, with small records and short follow-up. However, the authors agree in defi ning this procedure as a valid option in these patients.This chapter reviewed indications, surgical techniques, and outcomes of TKA to treat acute tibial plateau fracture.

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