Resumo

SALCEDO ZUNINO, Leandro A et al. Reemplazo total de rodilla en secuela de fracturas alrededor de la rodilla. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2017, vol.82, n.2, pp.102-108. ISSN 1852-7434.

Introduction: Surgical treatment for post-traumatic arthritis secondary to distal femur or proximal tibia periarticular fractures is uncommon and complex. Total knee arthroplasty is a valid option. Objectives: functional and radiological review of total knee arthroplasty after post-traumatic arthritis. Methods: Retrospective multicenter review of 29 patients (19 women and 10 men; average age: 59 years) who underwent total knee arthroplasty for post-traumatic arthritis during 2008-2015. Twenty-three were secondary to proximal tibial fractures and 6 to distal femur fractures; 6 were extra-articular and 23 intra-articular. Initial treatment was non-surgical in 8 patients, open reduction and internal fixation was performed in 21. Surgeries before arthroplasty: 2.14. Patients were followed with the Knee Society Score (KSS) as well as radiological assessment. Preoperative range of motion was: flexion 60o (45-90) and extension 15o (0-90). Pain KSS 30 (10-45), functional KSS 25 (20-45), total KSS 30 (20-60). Results: Follow-up of 45 months. The range of motion improved flexion 112o (60-140) and extension 5o (0-30). KSS for pain 40 (30-50), functional KSS 35 (30-50), total KSS 81 (50- 95). Results were good (KSS ≥80) in 22 patients (75.8%), regular in 6 (20.6%), and poor in one case (3.44%). Mechanical axis was restored in all cases. Mayor complications: 13%. Conclusions: Total knee arthroplasty after post-traumatic arthritis is a technically demanding surgery. Although the rate of complications is higher than that of total knee arthroplasty for the treatment of primary knee osteoarthritis, it is a good procedure for complex reconstructions, relieving pain and improving functional outcomes.

Palavras-chave : Total knee arthroplasty; Post-traumatic; Arthritis.

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