Knee arthroplasty for acute fractures around the knee
Thomas Tampere, Matthieu Ollivier, Christophe Jacquet, Maxime Fabre-Aubrespy, and Sébastien ParratteKnee
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Results of open reduction and internal fixation for complex articular fractures around the knee are poor, particularly in elderly osteoporotic patients.
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Open reduction and internal fixation may lead to an extended hospital stay and non-weight-bearing period.
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This may lead to occurrence of complications related to decubitus such as thrombo-embolic events, pneumonia and disorientation.
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Primary arthroplasty can be a valuable option in a case-based and patient-specific approach. It may reduce the number of procedures and allow early full weight-bearing, avoiding the above-mentioned complications.
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There are four main indications:
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1) Elderly (osteoporotic) patients with pre-existing (symptomatic) end-stage osteoarthritis.
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2) Elderly (osteoporotic) patients with severe articular and metaphyseal destruction.
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3) Pathological fractures of the distal femur and/or tibia.
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4) Young patients with complete destruction of the distal femur and/or tibia.
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The principles of knee (revision) arthroplasty should be applied; choice of implant and level of constraint should be considered depending on the type of fracture and involvement of stabilizing ligaments. The aim of treatment is to obtain a stable and functional joint.
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Long-term data remain scarce in the literature due to limited indications.
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