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Total Knee Arthroplasty in a Transtibial Amputee
Sven E Putnis1, Thomas Neri1, Myles R J Coolican1
1Sydney Orthopaedic Research Institute, Level 1 The Gallery, Chatswood, NSW 2067, Australia.
Total knee arthroplasty (TKA) in transtibial amputees can be optimized using navigated tibial alignment. This technique improves functional outcomes and patient satisfaction, facilitating a return to work.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Transtibial amputees often achieve high function with advanced prosthetics.
- Increased functional demands place the ipsilateral knee at risk for osteoarthritis, necessitating total knee arthroplasty (TKA).
Observation:
- A novel technique for TKA in transtibial amputees using navigation and a tibial jig is presented.
- Postoperative radiographs showed varus tibial alignment with neutral limb alignment.
- Stump swelling resolved by 8 weeks, enabling prosthesis fitting.
Findings:
- A new prosthesis optimized functional alignment.
- Return to moderate labor was achieved by 10 weeks.
- Excellent patient satisfaction was reported at 1-year postoperatively.
Implications:
- Navigated TKA with stump alignment is a valuable technique for transtibial amputees.
- Radiographic tibial varus alignment, post-socket fitting, can achieve balanced knee loading and excellent function.
- This approach enhances functional recovery and patient satisfaction in this unique patient population.
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