Post-Traumatic Total Knee Arthroplasty: A Case of Hoffa Fracture Nonunion and Review of Literature

Abstract

Background: Post-traumatic arthroplasty is associated with higher rates of complications and overall inferior outcomes when compared with primary joint replacement. The literature revealed no precise guidelines on the management of nonunion of Hoffa fracture. Hence, we tried to elicit a management protocol in such patients from the literature perspective. Case Presentation: A 62-year-old patient survived a car accident with a distal femoral fracture in the coronal plane (Hoffa fracture) and was treated with open reduction and internal fixation (ORIF). Three years later, the patient developed nonunion with post-traumatic arthritis (PTA). Owing to joint degeneration and poor bone quality, the patient was treated with total knee arthroplasty (TKA). One year follow-up showed excellent outcomes. Conclusions: Inpatient with healthy joint surface and good bone density, treatment of choice should be ORIF and in those with joint degeneration and low bone stock, arthroplasty is a better choice.

Keywords

• Osteoarthritis
• Knee; Femoral Fracture; Fracture
• Ununited; Knee Arthroplasty