Primary Total Knee Replacement in a Case of Lateral Tibial Condyle Delayed Union with Severe Grade 4 Osteoarthritis Knee – A Case Report

INTRODUCTION: Tibial plateau fractures are not uncommon. These fractures occur in bimodal age distribution consisting of 8% of all geriatric fractures. They usually occur as a result of low-energy trauma in the elderly. The management options include closed/open reduction and internal fixation (ORIF...

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Autores principales: Mahajan, Neetin P, Chandanwale, Ajay S, G S, Prasanna Kumar, Harsoor, Abhishek, Gadod, Lalkar, Sadar, Amey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706449/
https://www.ncbi.nlm.nih.gov/pubmed/33312967
http://dx.doi.org/10.13107/jocr.2020.v10.i05.1810
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author Mahajan, Neetin P
Chandanwale, Ajay S
G S, Prasanna Kumar
Harsoor, Abhishek
Gadod, Lalkar
Sadar, Amey
author_facet Mahajan, Neetin P
Chandanwale, Ajay S
G S, Prasanna Kumar
Harsoor, Abhishek
Gadod, Lalkar
Sadar, Amey
author_sort Mahajan, Neetin P
collection PubMed
description INTRODUCTION: Tibial plateau fractures are not uncommon. These fractures occur in bimodal age distribution consisting of 8% of all geriatric fractures. They usually occur as a result of low-energy trauma in the elderly. The management options include closed/open reduction and internal fixation (ORIF) using screws and plates. The osteosynthetic treatment options cause malreduction, non-union, implant failure in elderly patients due to osteoporosis and this may lead to post-traumatic arthritis, requiring total knee replacement (TKR) as a secondary procedure later. CASE REPORT: A 76-year-old male patient presented with pain and swelling in the left knee with a history of trauma to the left knee. X-ray of the left knee showed the split fracture of the left lateral tibial condyle with severe Grade 4 osteoarthritis. On examination, tenderness was present over the lateral tibial condyle. We managed with cemented primary TKR using stemmed tibial component. Postoperatively, the patient is having good knee range of motion and having no difficulty in walking and weight-bearing. Functional outcome is good as per Oxford knee score. CONCLUSION: Primary TKR is a viable alternative treatment option compared to ORIF in elderly patients with preexisting osteoarthritis with tibial condyle fractures. It helps in early mobilization, weight-bearing and avoids secondary surgical procedures.
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spelling pubmed-77064492020-12-11 Primary Total Knee Replacement in a Case of Lateral Tibial Condyle Delayed Union with Severe Grade 4 Osteoarthritis Knee – A Case Report Mahajan, Neetin P Chandanwale, Ajay S G S, Prasanna Kumar Harsoor, Abhishek Gadod, Lalkar Sadar, Amey J Orthop Case Rep Case Report INTRODUCTION: Tibial plateau fractures are not uncommon. These fractures occur in bimodal age distribution consisting of 8% of all geriatric fractures. They usually occur as a result of low-energy trauma in the elderly. The management options include closed/open reduction and internal fixation (ORIF) using screws and plates. The osteosynthetic treatment options cause malreduction, non-union, implant failure in elderly patients due to osteoporosis and this may lead to post-traumatic arthritis, requiring total knee replacement (TKR) as a secondary procedure later. CASE REPORT: A 76-year-old male patient presented with pain and swelling in the left knee with a history of trauma to the left knee. X-ray of the left knee showed the split fracture of the left lateral tibial condyle with severe Grade 4 osteoarthritis. On examination, tenderness was present over the lateral tibial condyle. We managed with cemented primary TKR using stemmed tibial component. Postoperatively, the patient is having good knee range of motion and having no difficulty in walking and weight-bearing. Functional outcome is good as per Oxford knee score. CONCLUSION: Primary TKR is a viable alternative treatment option compared to ORIF in elderly patients with preexisting osteoarthritis with tibial condyle fractures. It helps in early mobilization, weight-bearing and avoids secondary surgical procedures. Indian Orthopaedic Research Group 2020 /pmc/articles/PMC7706449/ /pubmed/33312967 http://dx.doi.org/10.13107/jocr.2020.v10.i05.1810 Text en Copyright: © Indian Orthopaedic Research Group http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Mahajan, Neetin P
Chandanwale, Ajay S
G S, Prasanna Kumar
Harsoor, Abhishek
Gadod, Lalkar
Sadar, Amey
Primary Total Knee Replacement in a Case of Lateral Tibial Condyle Delayed Union with Severe Grade 4 Osteoarthritis Knee – A Case Report
title Primary Total Knee Replacement in a Case of Lateral Tibial Condyle Delayed Union with Severe Grade 4 Osteoarthritis Knee – A Case Report
title_full Primary Total Knee Replacement in a Case of Lateral Tibial Condyle Delayed Union with Severe Grade 4 Osteoarthritis Knee – A Case Report
title_fullStr Primary Total Knee Replacement in a Case of Lateral Tibial Condyle Delayed Union with Severe Grade 4 Osteoarthritis Knee – A Case Report
title_full_unstemmed Primary Total Knee Replacement in a Case of Lateral Tibial Condyle Delayed Union with Severe Grade 4 Osteoarthritis Knee – A Case Report
title_short Primary Total Knee Replacement in a Case of Lateral Tibial Condyle Delayed Union with Severe Grade 4 Osteoarthritis Knee – A Case Report
title_sort primary total knee replacement in a case of lateral tibial condyle delayed union with severe grade 4 osteoarthritis knee – a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706449/
https://www.ncbi.nlm.nih.gov/pubmed/33312967
http://dx.doi.org/10.13107/jocr.2020.v10.i05.1810
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