Jabalameli, M., Hadi, H., Bagheri Fard, A., rahbar, M., minator sajjadi, M. (2018). Long- Stem Total Knee Arthroplasty for Proximal Tibial Stress Fractures in the Elderly Patients. The Archives of Bone and Joint Surgery, (), -. doi: 10.22038/abjs.2017.25955.1698
Mahmoud Jabalameli; Hosseinali Hadi; Abolfazl Bagheri Fard; mohammad rahbar; mohammadreza minator sajjadi. "Long- Stem Total Knee Arthroplasty for Proximal Tibial Stress Fractures in the Elderly Patients". The Archives of Bone and Joint Surgery, , , 2018, -. doi: 10.22038/abjs.2017.25955.1698
Jabalameli, M., Hadi, H., Bagheri Fard, A., rahbar, M., minator sajjadi, M. (2018). 'Long- Stem Total Knee Arthroplasty for Proximal Tibial Stress Fractures in the Elderly Patients', The Archives of Bone and Joint Surgery, (), pp. -. doi: 10.22038/abjs.2017.25955.1698
Jabalameli, M., Hadi, H., Bagheri Fard, A., rahbar, M., minator sajjadi, M. Long- Stem Total Knee Arthroplasty for Proximal Tibial Stress Fractures in the Elderly Patients. The Archives of Bone and Joint Surgery, 2018; (): -. doi: 10.22038/abjs.2017.25955.1698
Long- Stem Total Knee Arthroplasty for Proximal Tibial Stress Fractures in the Elderly Patients
1Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran IR Iran
2arak university of medical science
3arashsajadi55@yahoo.com
Abstract
Purpose: Because of the poor bone stock, it is not infrequent that elderly patients may present with stress fracture of the proximal tibia. The optimal management of patients with severe gonarthrosis of the knee and concurrent tibial stress fracture is not known. In this study we report the outcome of primary total knee arthroplasty (TKA) using stemmed components in this group of patients. Methods: Between 2009 and 2014, 16 elderly patients with proximal tibial stress fractures and concurrent gonarthrosis were treated with TKA using long stemmed components at our institution. Diagnosis of stress fractures was based on changes seen on radiographs. Standing alignment view was obtained for all patients preoperatively. Union of the fracture site was investigated using plain anteroposterior (AP) and lateral leg x-rays. Results: All patients experienced significant relieve of symptoms. The Knee Society score and Knee Society functional score averaged 86±4 and 85±6, respectively. The mean arc of motion of the knee was 118 ±2 degrees at the latest follow-up. All stress fractures resolved at a mean of 8.3±1.1 weeks. Medial proximal tibial angle increased from 74.7±5.7 preoperatively to 90.3±1.1 degrees (p<0.001) postoperatively. Tegner activity scale increased from 2.1±1.3 to 3.4±0.9 (p<0.001). Conclusion: Based on this case series, it appears that patients with stress fracture of proximal tibia and concurrent gonarthrosis may be treated with primary TKA using stemmed components that may bypass the stress fracture and allow healing of the fracture.
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