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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Total knee replacement following intra-articular malunion
S Parratte1, P Boyer, P Piriou
1Arthritis Surgery Center, Sainte-Marguerite hospital, University Hospital Center South, 270, boulevard Sainte-Marguerite, 13009 Marseille, France.
Orthopaedics & Traumatology, Surgery & Research : OTSR
|September 28, 2011
Summary
Total knee replacement (TKR) for knee osteoarthritis with intra-articular malunion shows improved scores but carries a high complication risk. Patients face potential stiffness and limited flexion, requiring informed consent regarding outcomes.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Limited data exists on managing knee osteoarthritis (OA) secondary to intra-articular malunion.
- Intra-articular malunion presents unique challenges for total knee replacement (TKR).
Purpose of the Study:
- To analyze TKR outcomes for knee OA with intra-articular malunion.
- To report complications and technical aspects of TKR in this specific patient group.
Main Methods:
- Retrospective multicenter study of 74 patients undergoing TKR for post-traumatic knee OA with intra-articular malunion.
- Mean follow-up of 4 years, assessed using the Knee Society score (modified).
Main Results:
- Significant improvement in knee and functional scores (P<0.001 and P=0.004, respectively).
- Mean flexion gain of 6°, with postoperative flexion averaging 110°.
- High complication rate (26%), including severe issues like extensor avulsions, infections, and stiffness.
Conclusions:
- TKR for knee OA with intra-articular malunion is associated with elevated complication rates and poorer functional results compared to OA from constitutional deformity.
- Pre-existing trauma and fibrosis can lead to stiffness and surgical challenges.
- Patients must be informed about the potential for limited postoperative flexion, especially if initial stiffness is present.
