Proximal Tibial Fracture Following Total Knee Arthoplasty

Abstract Purpose To investigate, if patients with complex proximal tibial fracture have realistic expectations on open reduction and internal fixation. Methods 114 patients (mean 49 years, SD ± 13) with closed AO-type B and C proximal tibial fracture were grouped (group B, respectively C). Prior to surgery expectations concerning knee function, pain, return to work/sports, and the risk for osteoarthritis was assessed with the Hospital for Special Surgery-Knee Surgery Expectations Survey (HFSS-KSE) and a non-validated ten-item survey. Results 92% of patients expected at least an almost natural knee postoperatively. All items regarding restoring knee function were ranked to be at least important in both groups. 65% in group B and 47% in group C expected at most occasional pain. 83% in group B and 67% in group C expected full return to work without any limitations. Patients with low physical work intensity expected significantly shorter incapacity to work in both groups (7.8, respectively 8.9 weeks). 71% in group B and 60% in group C expected to return to sports with at most small limitations. 33% in group B and 22% in group C assumed risk for osteoarthritis will be prevented by surgery. Conclusion Expectations on surgery for complex proximal tibial fracture are high regardless of fracture type. The prognosis of many health and lifestyle domains was overestimated. The risk for osteoarthritis was underestimated. This study should sensitize surgeons to discuss realistic expectations. This may help to improve patient comprehension what leads to sensible expectations, resulting in improved patients´ satisfaction. Level of evidence IV. Trial registration number 14104, Date of registration: 06/2015.

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Functional outcome of patellar resurfacing vs non resurfacing in Total Knee Arthoplasty in elderly: A prospective five year follow-up study

Journal of Arthroscopy and Joint Surgery ◽

10.1016/j.jajs.2018.09.006 ◽

2019 ◽

Vol 6 (1) ◽

pp. 65-69

Author(s):

Lokesh Chawla ◽

Shivanand M. Bandekar ◽

Vivek Dixit ◽

Ambareesh P ◽

Arun Krishnamoorthi ◽

...

Keyword(s):

Functional Outcome ◽

Patellar Resurfacing ◽

Follow Up Study ◽

Total Knee ◽

Total Knee Arthoplasty

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Is there a need for early post-operative x-rays in primary total knee replacements? Experience of a centre in the UK

Annals of The Royal College of Surgeons of England ◽

10.1308/003588412x13171221501780 ◽

2012 ◽

Vol 94 (3) ◽

pp. 199-200 ◽

Cited By ~ 7

Author(s):

S Hassan ◽

A Wall ◽

B Ayyawamy ◽

S Rogers ◽

SP Mills ◽

...

Keyword(s):

Tibial Fracture ◽

Operative Management ◽

X Rays ◽

Inferior Pole ◽

Total Knee Replacements ◽

Knee Replacements ◽

Total Knee ◽

The Uk ◽

Primary Total Knee

INTRODUCTION Early post-operative x-rays are often taken in total knee replacements (TKRs). Patient mobilisation may be delayed until these x-rays are obtained and this may prolong discharge. The aim of this study was to assess the value of such early x-rays and whether they influenced the early post-operative management of these patients. METHODS A total of 624 consecutive TKRs performed at the Blackpool Victoria Hospital over a 34-month period were evaluated. Plain anteroposterior and lateral x-rays were examined. RESULTS Two patients were found to have significant abnormalities: an undisplaced peri prosthetic tibial fracture and a partial inferior pole patellar avulsion. Neither of these required further treatment or influenced mobility. No other complications were noted that changed routine post-operative management. CONCLUSIONS These results question the need for immediate x-rays in primary TKRs.

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2071378 Ultrasound-Guided Hydrodissection of The Iliotibial Band after Total Knee Arthoplasty: Case Report

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2014.12.458 ◽

2015 ◽

Vol 41 (4) ◽

pp. S113

Author(s):

Lawrence Lai ◽

Varun Patibanda ◽

Gloria Hwang ◽

Todd Stitik ◽

Patrick Foye ◽

...

Keyword(s):

Case Report ◽

Iliotibial Band ◽

Ultrasound Guided ◽

Total Knee ◽

Total Knee Arthoplasty

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Comparison between External Locking Plate Fixation and Conventional External Fixation for Extraarticular Proximal Tibial Fractures: A Finite Element Analysis

10.21203/rs.3.rs-955261/v1 ◽

2021 ◽

Author(s):

Dejan Blažević ◽

Janoš Kodvanj ◽

Petra Adamović ◽

Dinko Vidović ◽

Zlatko Trobonjača ◽

...

Keyword(s):

Finite Element ◽

External Fixation ◽

External Fixator ◽

Tibial Fracture ◽

Locking Plate ◽

Plate Fixation ◽

Tibial Fractures ◽

Proximal Tibial Fracture ◽

Locking Plate Fixation ◽

Maximum Stiffness

Abstract BackgroundGood clinical outcomes for locking plates as an external fixator to treat tibial fractures have been reported. However, external locking plate fixation is still generally rarely performed. This study aimed to compare the stability of external locking plate fixator with that of conventional external fixator for extraarticular proximal tibial fractures, using finite element analysis. MethodsThree models were constructed: (1) external locking plating of proximal tibial fracture with lateral proximal tibial locking plate and 5-mm screws (ELP), (2) conventional external fixation of proximal tibial fracture with an 11-mm rod and 5-mm Schanz screws (EF-11), and (3) conventional external fixation of proximal tibial fracture with a 7-mm rod and 5-mm Schanz screws (EF-7). The stress distribution, displacement at the fracture gap, and stiffness of the three finite element models at 30-, 40-, 50-, and 60-mm plate–rod offset from the lateral surface of the lateral condyle of the tibia were determined. ResultsThe conventional external fixator showed higher stiffness than did the external locking plate fixator. In all models, the stiffness decreased as the distance of the plate–rod from the bone surface increased. The maximum stiffness was 121.06 N/mm in the EF-11 model with 30-mm tibia–rod offset. In the EF-7 model group, the maximum stiffness was 40.00 N/mm in the model with 30-mm tibia–rod offset. In the ELP model group, the maximum stiffness was 35.79 N/mm in the model with 30-mm tibia–plate offsetConclusionsExternal locking plate fixation is more flexible than conventional external fixation, which can influence secondary bone healing. External locking plate fixation requires the placement of the plate as close as possible to the skin, which allow low-profile design, because the increased distance of the plate from bone can be too flexible for bone healing.

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