Total knee replacement after fractures about the knee.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Posttraumatic arthritis frequently develops after knee fractures.
• Total knee replacement (TKR) is a common treatment for severe cases.
• Fracture malunions present unique challenges for TKR.

Purpose of the Study:

• To evaluate the clinical outcomes of TKR in patients with posttraumatic arthritis secondary to knee fractures.
• To identify key technical considerations and potential complications in TKR following knee fractures, particularly malunions.

Main Methods:

• Retrospective review of 17 cases undergoing TKR for posttraumatic knee arthritis.
• Analysis of preoperative radiographic parameters, including tibial plateau tilt and angular deformities.
• Assessment of intraoperative and postoperative complications and clinical outcomes at a minimum one-year follow-up.

Main Results:

• Eight out of thirteen patients with at least one-year follow-up achieved successful clinical results.
• Five patients experienced unsuccessful outcomes, all associated with major intraoperative or postoperative complications.
• Preoperative tibial plateau tilt in intra-articular fractures and varus/valgus deformities in extra-articular fractures were significant considerations.

Conclusions:

• TKR can be successful for posttraumatic knee arthritis, but outcomes are influenced by fracture characteristics.
• Meticulous preoperative planning, addressing tibial plateau tilt and bony deformities, is essential.
• Prearthroplasty osteotomy may be necessary for significant deformities, and careful surgical planning is required to optimize results and minimize revision-like scenarios.