Proximal Tibia Stress Fracture Caused by Primary Degenerative Knee Osteoarthritis with Varus Deformity

2016 ◽  
Vol 51 (5) ◽  
pp. 437
Author(s):  
Joong-Myung Lee ◽  
Young-Woo Kwon
Keyword(s):  
Knee Osteoarthritis ◽  
Stress Fracture ◽  
Proximal Tibia ◽  
Varus Deformity

scholarly journals Knee Arthroplasty in Severe Varus Advanced Knee Osteoarthritis with Proximal Tibia Malunion: a case report

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0005
Author(s):  
Nyoman Aditya Sindunata ◽  
Prettysia Suvarly ◽  
Rio Aditya ◽  
John Butarbutar
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Proximal Tibia ◽  
Varus Deformity ◽  
Left Knee ◽  
Tibial Osteotomy ◽  
Posterior Stabilized ◽  
Stem Extension ◽  
Closed Wedge ◽  
And Function

Alignment is crucial for successful knee arthroplasty.1 Tibia malunion will make arthroplasty more challenging. In this case, we present advanced knee osteoarthritis with tibia vara due to malunion that needs corrective osteotomy during knee arthroplasty. Case Presentation: A 70 years old female presented to our office complaining pain in both knees markedly on the left, profoundly felt during walking. She has a history of being hit by motorcycle 15 months ago and left knee was more bent since then. Physical examination of the left knee showed severe varus, mild effusion, tenderness on medial tibial condyle, otherwise normal. Plain radiographs showed advanced bilateral knee osteoarthritis with left proximal tibia malunion. Patient underwent left knee arthroplasty with corrective tibia and fibula osteotomy. Solutions and Outcome: Patient underwent closed wedge tibial osteotomy together with fibula osteotomy followed by knee arthroplasty with posterior-stabilized implant and tibial stem extension in a single surgery. Tibial osteotomy was reinforced using plate and screws. Partial weight bearing was achieved in second postoperative day and discharged on the third day. Patient able to walk with painless left knee after 1 month. Discussion: Severe deformity that causes huge malalignment makes knee arthroplasty difficult. Some methods are available to correct malalignment.1 In this case, the surgeon chose to do closed wedge tibial osteotomy reinforced with plate and screws to correct the proximal tibia malunion. Arthroplasty was done using posterior-stabilized implant and tibial stem extension. Patient shows good result in alignment and function. Conclusion: Correcting the associated deformity is crucial in achieving good alignment in knee arthroplasty. Even in our case of severe genu varus due to proximal tibia malunion, correcting proximal tibia varus deformity prior to knee arthroplasty shows good alignment and function. References: Mullaji AB, Padmanabhan V, Jindal G. Total Knee Arthroplasty for Profound Varus Deformity. 2005;20(5):550–61.

scholarly journals Proximal tibia stress fracture with Osteoarthritis of knee − Radiological and functional analysis of one stage TKA with long stem

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 13 ◽  
Author(s):  
Dhanasekaran Soundarrajan ◽  
Natesan Rajkumar ◽  
Palanisamy Dhanasekararaja ◽  
Shanmuganathan Rajasekaran
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Outcome ◽  
Stress Fracture ◽  
Proximal Tibia ◽  
Fracture Site ◽  
Stress Fractures ◽  
One Stage ◽  
The Mean ◽  
Long Stem

Introduction: Proximal tibia stress fractures with knee osteoarthritis pose a challenging situation. We evaluated the radiological and functional outcome of one-stage total knee arthroplasty (TKA) and long stem for patients with varied grades of knee arthritis and proximal tibia stress fractures.  Methods: We analysed 20 patients from April 2012 to March 2017 with proximal tibia stress fractures associated with knee osteoarthritis of varied grades. Out of 20 patients, five were acute fresh fractures. The mean age was 64 years (range, 52–78) which includes three men and 17 women. Previous surgery in the same limb, rheumatoid arthritis, valgus deformity were excluded. All patients were treated with posterior stabilised TKA with long stem, of which, four patients had screw augmentation for medial tibial bone defect and two patients with malunited fracture at stress fracture site required osteotomy, plating and bone grafting. Two patients had two level stress fracture of tibia in the same leg. Results: The mean follow-up period was 28 (range, 6–60) months. The mean tibiofemoral angle improved from 18.27° varus to 1.8° valgus. The mean knee society score improved from 21.9 (range, −10 to 45) to 82.8 (range, 15–99) [p < 0.05]. The mean Knee Society functional score improved from 15.5 (range, −10 to 40) to 76.8 (range, 10–100) [p < 0.05]. All fractures got united at the last follow-up. One patient had infection and wound dehiscence at six months for which debridement done and had poor functional outcome. Conclusion: TKA with long stem gives excellent outcome, irrespective of severity of arthritis associated with stress fracture. By restoring limb alignment and bypassing the fracture site, it facilitates fracture healing. Early detection and prompt intervention is necessary to prevent the progression to recalcitrant non-union or malunion.

scholarly journals The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformity

2018 ◽  
Vol 53 (6) ◽  
pp. 754-760
Author(s):  
Leonardo Antunes Bellot de Souza ◽  
Vinícius Magno da Rocha ◽  
Max Rogerio Freitas Ramos
Keyword(s):  
Knee Osteoarthritis ◽  
Varus Deformity ◽  
Tibial Osteotomy

The effect of the dimensions of the distal femur and proximal tibia joint surfaces on the development of knee osteoarthritis

2015 ◽  
Vol 28 (5) ◽  
pp. 672-677 ◽  
Author(s):  
Derya Işik ◽  
Çetin Işik ◽  
Nihal Apaydin ◽  
Yusuf Üstü ◽  
Mahmut Uğurlu ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Distal Femur ◽  
Proximal Tibia ◽  
Joint Surfaces

The radiographic predictors of symptom severity in advanced knee osteoarthritis with varus deformity

The Knee ◽  
2011 ◽  
Vol 18 (6) ◽  
pp. 456-460 ◽  
Author(s):  
Chong Bum Chang ◽  
In Jun Koh ◽  
Eun Seok Seo ◽  
Yeon Gwi Kang ◽  
Sang Cheol Seong ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Symptom Severity ◽  
Varus Deformity

Relationship Between Low Bone Mineral Density and Varus Deformity in Postmenopausal Women with Knee Osteoarthritis

2009 ◽  
Vol 36 (3) ◽  
pp. 592-597 ◽  
Author(s):  
YASUSHI AKAMATSU ◽  
NAOTO MITSUGI ◽  
NAOYA TAKI ◽  
RYOHEI TAKEUCHI ◽  
TOMOYUKI SAITO
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Knee Osteoarthritis ◽  
Structural Changes ◽  
Tibial Plateau ◽  
Varus Deformity ◽  
Varus Knee ◽  
Mineral Density ◽  
Femorotibial Angle ◽  
Knee Oa

Objective.To assess the relationship between bone mineral density (BMD) and varus deformity arising from bone structural changes caused by knee osteoarthritis (OA) in postmenopausal women.Methods.This cross-sectional study involved 135 consecutive postmenopausal female patients who had varus knee OA and a Kellgren-Lawrence grade ≥ 2. Knee radiographs were obtained with the patient standing on one leg, and subjects were classified into 3 tertile groups according to femorotibial angle, which was taken as a measure of varus knee OA severity. We also measured the 3 subangles that make up the femorotibial angle, and focused on the varus inclination of the tibial plateau. BMD was measured in the lumbar spine, femoral neck, and medial and lateral tibial condyles using dual-energy X-ray absorptiometry. Differences between femorotibial angle tertile groups were assessed, and associations between femorotibial sub-angles and BMD values at various points were evaluated.Results.After adjustment for age and body mass index, there was no significant association between the varus inclination of the tibial plateau and lumbar spine BMD. A weak but statistically significant negative correlation existed between varus inclination of the tibial plateau and BMD at the ipsilateral proximal femur and lateral tibial condyle.Conclusion.Varus inclination of the tibial plateau was significantly more severe in the femorotibial angle tertile 3 group, and in patients with lower BMD in the ipsilateral lower limb. Varus knee OA may result not only from cartilage loss but also from structural changes of the bone.

Sign in / Sign up

Export Citation Format

Share Document