Total knee arthroplasty following prior distal femoral fracture

Papadopoulos, E.; Parvızı, Javad; Lai, Choon Hin; Lewallen, David G.

doi:10.1016/s0968-0160(02)00046-7

Cited by 138 publications

(108 citation statements)

References 20 publications

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“…50 The same study group in a different paper performed delayed knee arthroplasty for non-union in native knees. 51 Although radiological outcome was satisfactory, 14% developed infections, 20% required manipulation for stiffness and 10% had aseptic loosening. Similarly, a study examining the treatment of failed internal fixation by knee arthroplasty is technically demanding.…”

Section: Retrograde Im Fixationmentioning

confidence: 94%

A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures — An alternative treatment option

Atrey

Hussain²,

Gosling³

et al. 2017

Journal of Orthopaedics

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Introduction: Although the use of an endoprosthesis for distal femoral fractures remains a valid treatment option the widespread use is in its infancy. Methodology: In this retrospective case series, we review cases of distal femoral fracture treated with endoprosthetic replacement (EPR). The outcomes we assessed were the time to start mobilising, the time to discharge, morbidity and mortality as well as an Oxford knee score to assess pain and function and also the early survivorship. 6 of the 11 from the cohort had existing Total Knee Replacements (TKRs) in situ. Results: There were 11 knees in our cohort with a mean age of 81.5 years (range 52-102 years). The median time to follow up was 3.5 years (range 1.6 to 5.5 years). The median times to theatre was 3 days and to discharge was 16 days. Oxford functional and pain scores were 32/48. Discussion: In the appropriate patient and fracture pattern, Endoprosthetic knee replacement is an excellent option in the treatment of distal femoral fractures whether associated with an existing TKR or not. The implant is more costly than traditional open reduction and internal fixation, but the earlier return to full mobility post-operatively may save on hospital/care home stay and free up hospital space and minimise complications.

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Section: Retrograde Im Fixationmentioning

confidence: 94%

A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures — An alternative treatment option

Atrey

Hussain²,

Gosling³

et al. 2017

Journal of Orthopaedics

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“…Some authors consider that when the deformity exceeds 10º in the tibial or femoral coronal plane, special consideration must be had due to the resulting complex instability [3,13,14,17]. Even if there is no consensus, most of the publications point out that unusual bone cuts can be used in patients with femoral deformities in the coronal and/or sagital plane of up to 20º, and we agree.…”

Section: Discussionmentioning

confidence: 55%

“…Regarding the surgical approach, in order to prevent skin and soft tissue necrosis, it is advisable to use one of the previous incisions [3,[13][14][15] 6, 11,12,14 , or otherwise keep a distance of at least 5 cm. between them.…”

Section: Pre-op Planning and Considerations About Surgical Techniquementioning

confidence: 99%

Total Knee Arthroplasty Associate with Extra-Articular Deformity

Vedoya¹,

Garabano²,

Sel³

2017

MOJOR

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Introduction: Satisfactory longterm results on total knee arthroplasty (TKA) depend on restitution of the limb's mechanical axis, correct positioning of the prosthesis, and appropriate balance of soft tissue. Patients with osteoarthritis of the knee associated with femoral or tibial extra-articular deformity require thorough preoperative planning in order to decide if the axis correction can be made through "unusual" intra-articular bone cuts or if it should be associated to an osteotomy.Methods: 22 TKA were performed in 20 patients with osteoarthritis of the knee associated to significant extra-articular deformity of post-traumatic etiology in 8 cases and post-osteotomy in 14 (8 femoral and 6 tibial). Results:In all cases the limb's axis was corrected through a TKA with "unusual" intra articular bone cuts, without need of an osteotomy. The clinical and functional evaluation was made through the Knee Society scoring system. The average score for clinical evaluation was of 24.3 points preoperatively and 86 points one year after surgery. As to the functional score, it improved from 34 points preop to 85.3 points one year after surgery. Discussion:There is not an undisputable criteria regarding the treatment of patients with symptomatic osteoarthritis of the knee associated with severe extra-articular deformity. Correction of the extra-articular deformity by intra articular "unusual" bone cuts at the time of TKA is indicated if these cuts do not affect the femoral insertions of the collateral ligaments of the knee. This method can be applied to angular deformities up to 20º in the femur and up to 30º in the tibia. Through this technique, we have achieved good results, after more than 7 year of follow up, in 20 among 22 of the operated patients.

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“…There are several studies in the literature in which prostheses with greater constriction were used for distal femoral fractures (11)(12)(13)(14)(15)(16) . Osteoarthrosis secondary to knee fractures causes bone losses that may give rise to technical difficulties because of unusual anatomy.…”

Section: Discussionmentioning

confidence: 99%