Total knee replacement for post traumatic degenerative arthritis / 中华创伤杂志

ABSTRACT

Objective To evaluate the results of total knee replacement (TKR) in treating post traumatic degenerative arthritis. Methods A retrospective study was carried out on the results of TKR that performed in 11 patients with post traumatic degenerative arthritis due to a previous fracture around knee from 1997 to 2002. There were one female and 10 males with an average age of 59 years (31 76 years). The time from fracture to TKR averaged 8.7 years (2 27 years). Internal fixation was performed in seven cases, among which the removal of the hardware at one stage at the time of TKR was performed in four and TKR in three. Lateral retinacular release was done in four cases, extensor mechanism realignment in one and collateral ligament reconstruction in two at the time of TKR. Fracture malunion appeared in two cases during operation. Results All the cases were followed up for average 36 months (12 72 months). The mean pre operative Knee Society Scores for 37 scores (10 69 scores) for knee and 42 (0 60) for function were improved significantly to mean post operative 85 (10 100) and 75 (20 100), respectively. The mean knee arc of motion improved from pre operative 83?to post operative 93?. Post operative manipulation under anesthesia for poor motion was carried out in four knees. No knee had aseptic loosening that required subsequent revisions. One knee developed superficial infection treated with debridement and retention of components. Conclusions Significant improvement in function and relief in pain is seen in the patients with previous fractures following subsequent TKR. However, special efforts to restore limb alignment, ensure correct component position and manage soft tissue balance may improve outcome of TKA.