Total Knee Arthroplasty for Osteoarthritis Secondary to Fracture of the Tibial Plateau. A Prospective Matched Cohort Study

Lizaur-Utrilla, Alejandro; Collados-Maestre, Isabel; Miralles‐Muñoz, Francisco A.; Lopez‐Prats, Fernando A.

doi:10.1016/j.arth.2015.02.032

Cited by 70 publications

(75 citation statements)

References 17 publications

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“…The complication rate of 10.6% during the hospital stay was similar to the reported rate of 14% by Lizaur-Utrilla et al (including superficial infection, skin necrosis, knee stiffness, and partial rupture of the patellar tendon) 30 but lower than other reported rates of up to 63%. [2][3][4][5]15 In this study, the length of stay was not different between posttraumatic and standard TKA.…”

Section: Discussionsupporting

confidence: 86%

TKA for Posttraumatic Osteoarthritis Is More Complex and Needs More Surgical Resources

Dexel¹,

Beyer²,

Lützner³

et al. 2016

Orthopedics

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The purpose of this study was to evaluate the surgical effort of total knee arthroplasty (TKA) for posttraumatic osteoarthritis (PTOA) compared with primary osteoarthritis (OA). A total of 1841 TKAs were analyzed, including 170 patients with PTOA, that resulted from soft tissue trauma in 83 patients and fractures in 87 patients. Results showed that patients were significantly younger at the time of surgery in the posttraumatic group (62 vs 71 years; P<.001). Furthermore, fracture was associated with 3.7 years earlier need of TKA compared with soft tissue trauma. Operation time was significantly longer for both of the posttraumatic groups compared with OA (P<.001). Patients undergoing TKA after knee injuries are younger and surgical treatment is more challenging compared with TKA for OA. Extended operation time and implant systems with higher constraint and modular options are required. [Orthopedics. 2016; 39(3):S36-S40.].

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Section: Discussionsupporting

confidence: 86%

TKA for Posttraumatic Osteoarthritis Is More Complex and Needs More Surgical Resources

Dexel¹,

Beyer²,

Lützner³

et al. 2016

Orthopedics

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“…[20][21][22] Previous studies addressing the risk of failure following tibial plateau fractures have focused solely on the rate of conversion to TKA. 3,[23][24][25][26] The purpose of this study was to determine our institutional failure rate following open reduction and internal fixation (ORIF) of a tibial plateau fracture. For the purposes of this study, failure was considered a surgical intervention resulting in an ipsilateral TKA or OCA.…”

mentioning

confidence: 99%

Total Knee Arthroplasty versus Osteochondral Allograft: Prevalence and Risk Factors following Tibial Plateau Fractures

et al. 2018

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Orthopaedic surgeons commonly have the misconception that patients with tibial plateau fractures will likely go on to posttraumatic knee arthritis requiring total knee arthroplasty (TKA). In younger patients, osteochondral allograft (OCA) transplantation is an alternative method to address posttraumatic knee arthritis. The purpose of this study was (1) to identify our institutional failure rate following tibial plateau open reduction and internal fixation (ORIF) (failure was defined as conversion to TKA or OCA); (2) to determine if there are patient- or injury-related risk factors predictive of failure; and (3) to characterize differences between patients treated with TKA versus those treated with OCA transplantation. A 10-year retrospective review was conducted to identify patients treated at our institution with a tibial plateau fracture. Patients included in the final analysis were at least 18 years of age with an articular fracture (AO/OTA 41 B/C). The primary outcome was subsequent ipsilateral OCA or TKA. There were 350 patients (359 tibial plateau fractures) with a mean follow-up of 22.3 months (range, 6-133 months) who met inclusion criteria. Twenty-seven fractures (7.5%) were subsequently converted to a TKA or OCA at an average of 3.75 ± 3.1 years following their initial surgery. Patients who consumed tobacco were 2.3 times more likely to require a joint replacement (confidence interval [CI], 1.0-5.2; = 0.04). Those patients who received an OCAs were significantly younger as compared with their TKA peers, both at time of initial injury (37 vs. 51 years, = 0.02) and at time of surgery (41 vs. 55 years, = 0.009). The joint replacement rate in this study is similar to those studies in the published literature that focused solely on the prevalence of conventional TKA. Tobacco is a risk factor for failure following tibial plateau ORIF. Patients who were treated with an OCA were younger at time of injury and failure.

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“…Owing to compromise of the soft-tissue envelope, poor bone stock, ligamentous instability, and multiple prior operations with or without retained hardware, the incidence of complications and revisions was substantially higher in TKA performed for PTOA than for primary arthritis. In previous literature, the complication rate after TKA for PTOA was 17.2%-31.3%, with complications including delayed wound healing, superficial or deep surgical site infections, stiffness of the knee, periprosthetic fracture, and deep venous thrombosis, while reoperation rates ranged from 13.8%-20.8% 1,5,22,23 .…”

Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty in Patients with Prior Femoral and Tibial Fractures: Outcomes and Risk Factors for Surgical Site Complications and Reoperations

Wang

Zhou

Shao

et al. 2020

Orthopaedic Surgery

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Objective To investigate the outcomes of total knee arthroplasty (TKA) in patients with a prior femoral or tibial fracture, and identify the risk factors for surgical site complications and reoperations. Methods Seventy‐one TKAs performed in 71 patients with a prior tibial or femoral fracture between January 2005 and December 2016 were reviewed retrospectively. Forty males (40 knees) and 31 females (31 knees) were included. The mean age at the time of TKA was 59.2 (range, 29–83) years. Outcomes were assessed using the Knee Society score before surgery and at the final follow‐up visit. The patients' satisfaction rates were evaluated. Complications and reoperations were recorded by clinical and radiographic assessment. Logistic regression analysis was used to identify the risk factors for surgical site complications and reoperations. Results The median follow‐up period was 4.7 (range, 3.2–7.1) years. The median knee range of motion increased from 90° preoperatively to 110° at the latest follow‐up. The Knee Society knee score and function score improved from 35 (30, 40) and 40 (30, 50) to 90 (82, 93) and 90 (65, 100), respectively. The degree of overall satisfaction after TKA surgery was very satisfied in 41 patients, satisfied in 20 patients, neutral in four patients, dissatisfied in four patients, and very dissatisfied in two patients. The overall satisfaction (very satisfied and satisfied) rate was 85.9% (61 knees). Twelve knees (16.9%) had 19 surgical site complications. Six knees (8.3%) underwent reoperations, including one revision due to periprosthetic joint infection, one debridement and implant retention for superficial infection, two debridements for delayed wound healing, one open reduction and internal fixation for supracondylar fracture, and one re‐fixation and bone grafting for hardware failure after a combined femoral shaft osteotomy and TKA. Preoperative patella baja was diagnosed in 12 knees, and was identified as a risk factor for surgical site complications and reoperations. Conclusions TKA for post‐fracture osteoarthritis significantly relieved pain and improved function, but the incidence of surgical site complications and reoperations was high. Preoperative patella baja was a risk factor for surgical site complications and reoperations.

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Total Knee Arthroplasty for Osteoarthritis Secondary to Fracture of the Tibial Plateau. A Prospective Matched Cohort Study

Cited by 70 publications

References 17 publications

TKA for Posttraumatic Osteoarthritis Is More Complex and Needs More Surgical Resources

TKA for Posttraumatic Osteoarthritis Is More Complex and Needs More Surgical Resources

Total Knee Arthroplasty versus Osteochondral Allograft: Prevalence and Risk Factors following Tibial Plateau Fractures

Total Knee Arthroplasty in Patients with Prior Femoral and Tibial Fractures: Outcomes and Risk Factors for Surgical Site Complications and Reoperations

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