The Role of a Primary Arthroplasty in the Treatment of Proximal Tibia Fractures in Orthogeriatric Patients

Thomas Haufe, Stefan Förch, Peter Müller, Johannes Plath, Edgar Mayr, Thomas Haufe, Stefan Förch, Peter Müller, Johannes Plath, Edgar Mayr

Abstract

The total knee arthroplasty (TKA) is the gold standard for patients with an advanced symptomatic gonarthrosis. However, there are very few publications dealing with the primary TKA for patients with a proximal tibia fracture. In our retrospective study we evaluated 30 patients treated with a TKA for a proximal tibia fracture in our institution between 01/2008 and 12/2014. We collected the following statistical data from each patient: age, classification of the fracture (AO-classification), type of prosthesis used, length of the operation and hospitalization, and complications during the follow-up. We used the Knee Society Score (KSS) and the WOMAC score to evaluate the function. The Knee Society Score showed an average "general knee score" (KSS1) of 81.1 points and an average "functional knee score" (KSS2) of 74.5 points. The average WOMAC score was 78.6 points. Immediate postoperative mobilization with the possibility of a full-weight bearing is of crucial importance for the geriatric patients to maintain the mobility they had prior to the operation and reduce medical complications. Because of these advantages, the primary TKA seems to be a promising alternative to the ORIF of a proximal tibia fracture in the orthogeriatric patient.

Figures

Figure 1
Figure 1
Results of all patients (a) n = 22 (01/2008–12/2014) versus subgroup(s) n = 9 (01/2013–12/2014).
Figure 2
Figure 2
Female, age 83, tibia fracture AO 41B3, e.motion (Braun), postoperative X-ray, KSS1 83, KSS2 80, and WOMAC 87 (12th month's follow-up).
Figure 3
Figure 3
Female, age 86, tibia fracture AO 41C3, Innex SC (Zimmer), postoperative X-ray, KSS1 90, KSS2, and WOMAC 85 (13th month's follow-up).

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