Abstract
Failed fracture fixation about the knee due to nonunion combined with infection is
a difficult and challenging problem to treat. Concerns at the time of treatment include
persistent infection, nonunion, deformity, bone loss, compromised soft tissues, and
ligamentous instability. The primary objective in treatment includes eradication of
infection followed by a staged reconstruction procedure which involves a complex total
knee arthroplasty.
Key words
Infection - nonunion and failed fixation - juxtaarticular knee fractures - total knee
arthroplasty
References
- 1
Ali A M, El-Shafie M, Willett K M. et al .
Failure of fixation of tibial plateau fractures.
J Orthop Trauma.
2002;
16
323-329
- 2
Bolhofner B, Carmen B, Clifford P. et al .
The results of open reduction and internal fixation of distal femur fractures using
a biologic (indirect) reduction technique.
J Orthop Trauma.
1996;
10
372-377
- 3 Buckwalter-Einhorn T A, Bolander M E, Cruess R L. et al .Healing of the Musculoskeletal
Tissues. In: Rockwood C, Green D (eds). Fractures in Adults. JB Lippincott, Philadelphia
1996; 1972-2000
- 4
Farrell M J, Bryan R S.
Total knee arthroplasty after septic arthritis.
Orthop Clinic N Am.
1975;
6
1057
- 5
Freedman E L, Hak D J, Johnson E E. et al .
Total knee replacement including a modular distal femoral component in elderly patients
with acute fracture or non-union.
J Orthop Trauma.
1995;
9
231-237
- 6
Goldman R T, Scuderi G R, Insall J N.
2-stage reimplantation for infected total knee replacement.
Clin Orthop Rel Res.
1996;
331
118-124
- 7
Lee G C, Pagnano M W, Hanssen A D.
Total knee arthroplasty after prior bone or joint sepsis about the knee.
Clin Orthop Rel Res.
2002;
404
226-231
- 8
Lonner J H, Pedlow F X, Siliski J M.
Total knee arthroplasty for post traumatic arthrosis.
J Arthroplasty.
1999;
14
969-975
- 9
Roffi R P, Merritt P O.
Total knee replacement after fractures about the knee.
Orthop Rev.
1990;
19
614-620
- 10
Schatzker J, McBroom R, Bruce D.
The tibial plateau fracture. The Toronto experience 1968-1975.
Clin Orthop Rel Res.
1979;
138
94-104
- 11
Weiss N G, Parvizi J.
Total knee arthroplasty in patients with a prior fracture of the tibial plateau.
J Bone Joint Surg [Am].
2003;
85
218-221
Arthur L. MalkaniMD, Associate Professor
Department of Orthopaedic Surgery · University of Louisville
210 East Gray Street, Suite 1003
Louisville, KY 40202
Phone: Phone: 1/5 02-8 52-69 64
Fax: 1/5 02-8 52-72 27
Email: art.malkani@louisville.edu
Email: klmaye01@gwise.louisville.edu
