Post traumatic knee arthritis: navigated total knee replacement without hardware removal.
BACKGROUND
The Authors present the results of a series of navigated total knee replacements (TKR) without hardware removal in patients with post-traumatic arthritis following femoral fractures. The purpose of the paper was to determine the effectiveness of computer-assisted TKR in these patients compared to routine primary implants.


METHODS
Sixteen patients with post-traumatic knee arthritis following a distal femoral fracture and retained hardware were included in the study (group I). Patients in the study group were matched with patients who had undergone a computer navigated TKR using the same implant and software (group II). The indication for TKR in all group II patients was atraumatic arthritis and surgery was performed in the same period as the study group. Patients were matched for age, gender, pre-operative range of motion, severity of arthritis pre-operatively, type and grade of deformity and implant features.


RESULTS
There were no statistically significant differences in surgical time, hospital staying or intra-operative and post-operative complications between the two study groups. At the latest follow-up no statistically significant difference was seen for the Knee Society Score and WOMAC indices. Implant alignment and radiological parameters were similar in both groups.


CONCLUSIONS
This study demonstrated that post-traumatic knee arthritis following prior distal femoral fracture can be safely managed using a computer navigated TKR without hardware removal. Comparison between this patient group and a matched group with atraumatic arthritis showed similar post-operative results and complication rates.


METHODS
III.
Ist Orthopedic Department, C.T.O. Hospital, Via Bignami 1, 20100 Milan, Italy. Electronic address: alf.manzotti@libero.it.
Alfonso
A
Manzotti
Orthopaedic Department, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Chris
C
Pullen
Bioengineering Department, Politecnico di Milano, 20100 Milan, Italy.
Pietro
P
Cerveri
Clinica Ortopedica, Azienda Ospedaliera di Padova, Via Giustiniani 2, 35123 Padova, Italy.
Cesare
C
Chemello
Ist Orthopedic Department, C.T.O. Hospital, Via Bignami 1, 20100 Milan, Italy.
Norberto
N
Confalonieri
D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000209:etiology / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000601:surgery*; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011859:Radiography; D025321:Surgery, Computer-Assisted; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery