TOTAL KNEE ARTHROPLASTY AFTER PROXIMAL TIBIA FRACTURE

Abstract

We have analyzed the results of 32 TKA of 32 patients after fractures of the proximal tibia, which were operated in the period from 2011 to 2014. We have used intramedullary stems for tibial component in 28% of cases, CCK implants in 15.6% of cases, metal augments for bone defects in 25%, in 59.4% of cases autologous bone, cementation for minor defects was performed in 68.8% of patients. 12 of 32 (37.5%) operations were performed under the control of computer navigation (Orthopilot). Average KOOS score one year after the operation in subscales was as follows: "pain" - 86.1 (69,4-97,2), "daily physical activity" - 80,8 (57,4-92,6), "symptoms and stiffness "- 67,8 (57,1-85,7)," physical activity in sports"- 30,0 (5,0-70,0)," quality of life "- 50.0 (37,5- 81.3). The average ROM after the operation was as follows: flexion 100 degrees (90-120), extension 0 degrees (0-5), which corresponds to good and excellent results. There was only one case (3.1%) of septic instability, requiring a two-stage revisional surgery by articulating spacer. All the patients after surgery had a significant improvement of joint function and reduction of pain. However, these patients are at risk for postoperative complications and require a special approach when performing arthroplasty. Treatment outcomes are due to the restoration of axial and rotational alignment, normalization of the joint line by the use of augments, elimination of instability in the joint by application of CCK implants.

Keywords

• total knee arthroplasty
• fracture of the proximal tibia