Management of Pathologic Fractures around the Knee: Part 2-Proximal Tibia

Metastatic disease affecting the proximal tibia is rarer than disease affecting the femur; however, it presents unique challenges that the orthopaedic surgeon must address to ensure successful outcomes and return the patient to an ambulatory status. The essential workup for evaluating and treating these patients is addressed briefly in this review as a summary of the information is provided in part 1 of this series. Part 2 of this series will focus on the surgical treatment of these lesions, which can be complex and is not as well described in the literature. Procedures ranging from open reduction internal fixation with cement augmentation to complex endoprosthetic reconstruction can be employed to address proximal tibia metastatic disease. An awareness of these various treatment modalities allows the orthopaedic surgeon to plan the most effective operation for the patients under their care.