J Knee Surg 2020; 33(05): 496-503
DOI: 10.1055/s-0039-1679921
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Primary Total knee Arthroplasty: A Viable Surgical Option for Complex Tibial Plateau Fractures in Elderly

Ahmed Abdelbadie
1   Department of Orthopedic Surgery and Trauma, Suez Canal University Hospitals, Ismailia, Egypt
,
Ayman El-Hennawy
1   Department of Orthopedic Surgery and Trauma, Suez Canal University Hospitals, Ismailia, Egypt
,
1   Department of Orthopedic Surgery and Trauma, Suez Canal University Hospitals, Ismailia, Egypt
› Author Affiliations
Funding None.
Further Information

Publication History

16 June 2018

10 January 2019

Publication Date:
27 February 2019 (online)

Abstract

The optimal treatment of complex tibial plateau fractures in elderly is still controversial. The aim of the study was to retrospectively analyze the clinical and radiological outcomes of primary total knee arthroplasty (TKA) versus open reduction and internal fixation (ORIF) in elderly patients presenting with acute complex tibial plateau fractures. Between June 2011 and December 2015, we have analyzed the clinical outcomes of 22 primary total knee replacements and 21 ORIFs. The mean follow-up was 27 months. The intra- and postoperative complications, as well as the knee society score (KSS), were our outcome measures. The knee range of motion and the KSS knee and function scores were significantly better in the TKA patients compared with ORIF patients. Early postoperative full weight-bearing was allowed in the TKA patients with lower complications rate. In conclusion, primary TKA utilizing a stemmed tibial component is an effective treatment option for elderly patients with a complex acute fracture of the tibial plateau. This is a Type III therapeutic study.

Note

All procedures performed in studies involved human participants that were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


 
  • References

  • 1 Ali AM, Burton M, Hashmi M, Saleh M. Treatment of displaced bicondylar tibial plateau fractures (OTA-41C2&3) in patients older than 60 years of age. J Orthop Trauma 2003; 17 (05) 346-352
  • 2 McNamara IR, Smith TO, Shepherd KL. , et al. Surgical fixation methods for tibial plateau fractures. Cochrane Database Syst Rev 2015; 15 (09) CD009679
  • 3 Khatri K, Sharma V, Goyal D, Farooque K. Complications in the management of closed high-energy proximal tibial plateau fractures. Chin J Traumatol 2016; 19 (06) 342-347
  • 4 Pun TB, Krishnamoorthy VP, Poonnoose PM, Oommen AT, Korula RJ. Outcome of Schatzker type V and VI tibial plateau fractures. Indian J Orthop 2014; 48 (01) 35-41
  • 5 Phisitkul P, McKinley TO, Nepola JV, Marsh JL. Complications of locking plate fixation in complex proximal tibia injuries. J Orthop Trauma 2007; 21 (02) 83-91
  • 6 Vermeire J, Scheerlinck T. Early primary total knee replacement for complex proximal tibia fractures in elderly and osteoarthritic patients. Acta Orthop Belg 2010; 76 (06) 785-793
  • 7 Arnold MH. Fractures of the tibial plateau in the elderly as a cause of immobility. Aust N Z J Med 1995; 25 (02) 178
  • 8 Civinini R, Carulli C, Matassi F, Villano M, Innocenti M. Total knee arthroplasty after complex tibial plateau fractures. Chir Organi Mov 2009; 93 (03) 143-147
  • 9 Jain R. Complications of total knee arthroplasty after open reduction and internal fixation of fractures of the tibial plateau. J Bone Joint Surg Am 2002; 84-A (03) 497-500
  • 10 Saleh KJ, Sherman P, Katkin P. , et al. Total knee arthroplasty after open reduction and internal fixation of fractures of the tibial plateau: a minimum five-year follow-up study. J Bone Joint Surg Am 2001; 83-A (08) 1144-1148
  • 11 Scott CE, Davidson E, MacDonald DJ, White TO, Keating JF. Total knee arthroplasty following tibial plateau fracture: a matched cohort study. Bone Joint J 2015; 97-B (04) 532-538
  • 12 Weiss NG, Parvizi J, Hanssen AD, Trousdale RT, Lewallen DG. Total knee arthroplasty in post-traumatic arthrosis of the knee. J Arthroplasty 2003; 18 (03) (Suppl. 01) 23-26
  • 13 Lonner JH, Pedlow FX, Siliski JM. Total knee arthroplasty for post-traumatic arthrosis. J Arthroplasty 1999; 14 (08) 969-975
  • 14 Bufquin T, Hersan A, Hubert L, Massin P. Reverse shoulder arthroplasty for the treatment of three- and four-part fractures of the proximal humerus in the elderly: a prospective review of 43 cases with a short-term follow-up. J Bone Joint Surg Br 2007; 89 (04) 516-520
  • 15 Gambirasio R, Riand N, Stern R, Hoffmeyer P. Total elbow replacement for complex fractures of the distal humerus. An option for the elderly patient. J Bone Joint Surg Br 2001; 83 (07) 974-978
  • 16 Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968--1975. Clin Orthop Relat Res 1979; (138) 94-104
  • 17 Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 1989; (248) 13-14
  • 18 Asif S, Choon DS. Midterm results of cemented Press Fit Condylar Sigma total knee arthroplasty system. J Orthop Surg (Hong Kong) 2005; 13 (03) 280-284
  • 19 Parratte S, Pagnano MW, Trousdale RT, Berry DJ. Effect of postoperative mechanical axis alignment on the fifteen-year survival of modern, cemented total knee replacements. J Bone Joint Surg Am 2010; 92 (12) 2143-2149
  • 20 Ritter MA, Faris PM, Keating EM, Meding JB. Postoperative alignment of total knee replacement. Its effect on survival. Clin Orthop Relat Res 1994; (299) 153-156
  • 21 Morgan SS, Bonshahi A, Pradhan N, Gregory A, Gambhir A, Porter ML. The influence of postoperative coronal alignment on revision surgery in total knee arthroplasty. Int Orthop 2008; 32 (05) 639-642
  • 22 Ewald FC. The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 1989; (248) 9-12
  • 23 Thane PAT. History and the sociology of ageing. Soc Hist Med 1989; 2 (01) 93-96
  • 24 Wasserstein D, Henry P, Paterson JM, Kreder HJ, Jenkinson R. Risk of total knee arthroplasty after operatively treated tibial plateau fracture: a matched-population-based cohort study. J Bone Joint Surg Am 2014; 96 (02) 144-150
  • 25 Feeley I, Hegarty A, Hickey A, Glynn A. Impact of use of intramedullary and extramedullary guides on tibial component geometry in total knee replacements: a systematic review and meta-analysis. J Knee Surg 2016; 29 (06) 487-496
  • 26 Reed MR, Bliss W, Sher JL, Emmerson KP, Jones SM, Partington PF. Extramedullary or intramedullary tibial alignment guides: a randomised, prospective trial of radiological alignment. J Bone Joint Surg Br 2002; 84 (06) 858-860
  • 27 Karade V, Ravi B, Agarwal M. Extramedullary versus intramedullary tibial cutting guides in megaprosthetic total knee replacement. J Orthop Surg Res 2012; 7: 33
  • 28 Haufe T, Förch S, Müller P, Plath J, Mayr E. The role of a primary arthroplasty in the treatment of proximal tibia fractures in orthogeriatric patients. BioMed Res Int 2016; 2016: 6047876
  • 29 Parratte S, Bonnevialle P, Pietu G, Saragaglia D, Cherrier B, Lafosse JM. Primary total knee arthroplasty in the management of epiphyseal fracture around the knee. Orthop Traumatol Surg Res 2011; 97 (6, Suppl): S87-S94
  • 30 Nourissat G, Hoffman E, Hémon C, Rillardon L, Guigui P, Sautet A. [Total knee arthroplasty for recent severe fracture of the proximal tibial epiphysis in the elderly subject]. Rev Chir Orthop Repar Appar Mot 2006; 92 (03) 242-247
  • 31 Nau T, Pflegerl E, Erhart J, Vecsei V. Primary total knee arthroplasty for periarticular fractures. J Arthroplasty 2003; 18 (08) 968-971
  • 32 Kilian U. [Total knee replacement for primary treatment of intra-articular tibial head fractures in elderly patients]. Unfallchirurg 2003; 106 (12) 1046-1050
  • 33 Kini SG, Sathappan SS. Role of navigated total knee arthroplasty for acute tibial fractures in the elderly. Arch Orthop Trauma Surg 2013; 133 (08) 1149-1154
  • 34 Mahadevan D, Walter RP, Minto G, Gale TC, McAllen CJ, Oldman M. Combined femoral and sciatic nerve block vs combined femoral and periarticular infiltration in total knee arthroplasty: a randomized controlled trial. J Arthroplasty 2012; 27 (10) 1806-1811
  • 35 Lombardi AV, Berend KR, Adams JB. A rapid recovery program: early home and pain free. Orthopedics 2010; 33 (09) 656
  • 36 Husted H, Hansen HC, Holm G. , et al. What determines length of stay after total hip and knee arthroplasty? A nationwide study in Denmark. Arch Orthop Trauma Surg 2010; 130 (02) 263-268
  • 37 Kawakami K, Hiroshima R, Takaoka H. , et al. Risk factors affecting length of hospital stay after total knee arthroplasty in rheumatoid arthritis and osteoarthritis patients. Ann Rheum Dis 2015; 74 (Suppl. 02) 1064-1065
  • 38 Ahearn N, Oppy A, Halliday R. , et al. The outcome following fixation of bicondylar tibial plateau fractures. Bone Joint J 2014; 96-B (07) 956-962
  • 39 Ali AM. Outcomes of open bicondylar tibial plateau fractures treated with Ilizarov external fixator with or without minimal internal fixation. Eur J Orthop Surg Traumatol 2013; 23 (03) 349-355
  • 40 Ali AM, Burton M, Hashmi M, Saleh M. Outcome of complex fractures of the tibial plateau treated with a beam-loading ring fixation system. J Bone Joint Surg Br 2003; 85 (05) 691-699
  • 41 Ollivier M, Turati M, Munier M, Lunebourg A, Argenson JN, Parratte S. Balloon tibioplasty for reduction of depressed tibial plateau fractures: preliminary radiographic and clinical results. Int Orthop 2016; 40 (09) 1961-1966
  • 42 Barei DP, Nork SE, Mills WJ, Henley MB, Benirschke SK. Complications associated with internal fixation of high-energy bicondylar tibial plateau fractures utilizing a two-incision technique. J Orthop Trauma 2004; 18 (10) 649-657
  • 43 Biyani A, Reddy NS, Chaudhury J, Simison AJ, Klenerman L. The results of surgical management of displaced tibial plateau fractures in the elderly. Injury 1995; 26 (05) 291-297
  • 44 Barlow T, Scott P, Griffin D, Realpe A. How outcome prediction could affect patient decision making in knee replacements: a qualitative study. BMC Musculoskelet Disord 2016; 17: 304
  • 45 Barlow T, Clark T, Dunbar M, Metcalfe A, Griffin D. The effect of expectation on satisfaction in total knee replacements: a systematic review. Springerplus 2016; 5: 167
  • 46 de Achaval S, Kallen MA, Amick B. , et al. Patients' expectations about total knee arthroplasty outcomes. Health Expect 2016; 19 (02) 299-308
  • 47 Davidson E, Oliver W, White T. , et al. Tibial plateau fractures: when will I need a knee replacement? Orthopaedic proceedings. Br Editorial Soc Bone Joint Surg 2014; 96-B: 7-7
  • 48 El-Galaly A, Haldrup S, Pedersen AB, Kappel A, Jensen MU, Nielsen PT. Increased risk of early and medium-term revision after post-fracture total knee arthroplasty. Acta Orthop 2017; 88 (03) 263-268