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An Early Experience with a Novel Technique of Total Knee Arthroplasty for Osteoarthritic Knee with Coexistent Traumatic Tibia Diaphysis Fracture

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Abstract

Background

Treatment of tibia (upper third and diaphysis) fracture together with severe osteoarthritis (OA) poses challenge to an orthopedic surgeon. Traditionally, it is treated through three-stage surgeries, first fracture fixation followed by implant removal and finally surgery of total knee arthroplasty (TKA). Herein, we describe a novel TKA procedure using long-stemmed tibia component. This one-step technique not only addresses arthritis of the knee joint but also helps in assisting fixation of the fracture.

Materials and Methods

We reported outcomes of three female non-diabetic patients with OA who developed tibia shaft fracture following trauma. Range of motion and quadriceps strengthening exercise were initiated immediately after the procedure. X-rays anteroposterior and lateral views of the operated limbs were obtained at post-operative week-6 and week-12. We allowed the patients’ toe touch weight-bearing immediately after the surgery. The patients were progressed to full weight-bearing after confirming radiological union on the X-rays.

Results

At follow-up, all treated patients were able to mobilize with good range of motion of the operated knee and with union of the fracture. The American Knee society scores and WOMAC pain and stiffness scores improved significantly.

Conclusion

This novel technique offers one-stage solution to the complex situation of osteoarthritis of the knee with associated tibia shaft fracture, thereby reducing future hospital admissions/surgeries and associated costs and complications. Further, it allows faster rehabilitation.

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Abbreviations

OA:

Osteoarthritis

TKA:

Total knee arthroploasty

IM:

Intramedullary

AP:

Antero-posterior

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Acknowledgements

We acknowledge the help provided by Dr Udita Chandra in manuscript editing.

Funding

No funding was obtained.

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Authors and Affiliations

  1. Holy Spirit Hospital, Mahakali Caves Road, Andheri East, Mumbai, Maharashtra, 400093, India

    Sanjay Bhalchandra Londhe & Nicholas Antao

  2. Criticare Superspeciality Hospital, Andheri, Mumbai, India

    Ravi Vinod Shah

  3. Civil Hospital, Mehsana, Gujarat, India

    Pritesh Omprakash Agrawal

Authors
  1. Sanjay Bhalchandra Londhe
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  2. Ravi Vinod Shah
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  3. Pritesh Omprakash Agrawal
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  4. Nicholas Antao
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All authors have contributed significantly to the preparation of manuscript.

Corresponding author

Correspondence to Sanjay Bhalchandra Londhe.

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There are no competing interests.

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Institutional review board approval was obtained before the study. Also all patients were consented.

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This article does not contain any studies with human or animal subjects performed by the any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Londhe, S.B., Shah, R.V., Agrawal, P.O. et al. An Early Experience with a Novel Technique of Total Knee Arthroplasty for Osteoarthritic Knee with Coexistent Traumatic Tibia Diaphysis Fracture. JOIO 56, 110–115 (2022). https://doi.org/10.1007/s43465-021-00406-5

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  • DOI: https://doi.org/10.1007/s43465-021-00406-5

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