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Post traumatic knee arthritis: navigated total knee replacement without hardware removal.

Alfonso Manzotti1, Chris Pullen2, Pietro Cerveri3

  • 1Ist Orthopedic Department, C.T.O. Hospital, Via Bignami 1, 20100 Milan, Italy.

The Knee
|July 17, 2012
PubMed
Summary

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Computer-navigated total knee replacement (TKR) is effective for post-traumatic knee arthritis after femoral fractures, showing similar outcomes and complication rates to routine TKR in atraumatic arthritis cases.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Post-traumatic arthritis following distal femoral fractures often necessitates total knee replacement (TKR).
  • Retained hardware from initial fracture fixation can complicate TKR procedures.
  • Computer-navigated TKR offers potential advantages in precision for complex cases.

Purpose of the Study:

  • To evaluate the effectiveness of computer-navigated TKR without hardware removal in patients with post-traumatic knee arthritis.
  • To compare the outcomes of computer-navigated TKR in post-traumatic arthritis patients with a matched cohort undergoing routine TKR for atraumatic arthritis.

Main Methods:

  • A retrospective study comparing 16 patients with post-traumatic arthritis (group I) to 16 matched patients with atraumatic arthritis (group II).
Keywords:
ComputerFracturesHardwareKneeReplacement

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  • Both groups underwent computer-navigated TKR using identical implants and software.
  • Matching criteria included age, gender, pre-operative range of motion, arthritis severity, deformity, and implant features.

    • Main Results:

    • No significant differences were observed in surgical time, hospital stay, or complication rates between the groups.
    • Functional outcomes, assessed by Knee Society Score and WOMAC indices, were similar at latest follow-up.
    • Implant alignment and radiological parameters showed no significant differences between computer-navigated TKR with and without hardware removal.

    Conclusions:

    • Computer-navigated TKR is a safe and effective management option for post-traumatic knee arthritis secondary to distal femoral fractures, even with retained hardware.
    • The procedure yields comparable post-operative results and complication profiles to TKR performed for atraumatic arthritis.