Total knee arthroplasty after complex tibial plateau fractures.

ABSTRACT

Total knee arthroplasty following complex fractures of the tibial plateau is considered a challenge for orthopaedic surgeons and clinical outcomes may vary. A total of 29 total knee replacements were performed after a tibial plateau fracture 25 patients (16 women, 9 men; average age 57 years; mean follow-up 92 months) were available. We had two significative complications one partial avulsion of the patellar tendon, conservatively treated by bracing, and one case of deep venous thromboembolism, managed with low molecular weight heparin. In two cases (8%) there was a failure of the implant; nine cases were excellent, nine good, four fair and one poor. A percentage of patients with previous complex proximal tibia fractures had an increased rate of postoperative complications due to anatomical deformity, functional deficiency and post-traumatic arthritis and required solutions similar to revision surgery. Total knee arthroplasty is a suitable solution for the treatment of these challenging cases compared to primary knee replacement, final KSS score is generally lower, but improvement is similar due to poorer pre-operative scores.