Outcome Analysis of Single Stage Total Knee Arthroplasty with Long Tibial Stem in Complex Primary Osteoarthritis with Tibia Stress Fracture
Abstract
Introduction: The treatment of severe osteoarthritis of knee with proximal tibia stress fracture is daunting. There is no palpable treatment guideline for this condition. This study evaluates the functional and radiological outcomes of single staged long tibial stem total knee arthroplasty.
Materials and methods: In this retrospective cohort, 10 patients were enrolled with severe osteoarthritis of knee with tibia stress fracture from 2020 to 2023. All patients were operated with posterior stabilising long tibial stem total knee arthroplasty. Pre-operative and post-operative functional and radiological assessments were evaluated.
Results: The follow-up period ranged from 16 to 28 months, with a mean of 21 months. 15.2° varus was the average HKA angle (SD 3.68°). Knee range of motion increased from 106° (range 90 – 115°) to 127° (range 120 – 130°), while FFD improved from 16° (range 5 – 30°) to 1.5° (range 0 – 5°). Both the mean Knee Society score, and its functional score increased from 21.5 (range 5–35) to 78 (range 65–90) (p<0.001) and from 21.7 (range 4-42) to 89.3 (range 82-95) (p<0.001), respectively. All patients had fracture union during a follow-up period of three to six months (mean 3.90 months).
Conclusion: Stress fracture in not uncommon in elderly osteoarthritic patients, long tibial stem total knee replacement provides safe and sublime result. Extension rod provides better restoration of alignment and facilitates fracture healing.
Abstract | Reference
