title: Computer-assisted total knee arthroplasty after prior femoral fracture without hardware removal.
abstract: This study presents a consecutive series of patients who underwent total knee arthroplasty (TKA) after prior distal femoral fracture without hardware removal. The purpose of this study was to determine the effectiveness of computer-assisted TKA in patients with posttraumatic arthritis, specifically those with retained hardware after prior distal femoral fracture. The study group included a consecutive series of 16 patients who had developed posttraumatic knee arthritis after a distal femoral fracture with retention of hardware (group A). Patients in the study group were matched with patients who had undergone a computer-assisted TKA using the same implant and software (group B). The indication for TKA in all group B patients was atraumatic arthritis, and surgery was performed during the same period as that in the study group. Patients were matched for age, sex, preoperative range of motion, preoperative severity of arthritis, type and grade of deformity, and implant features. No statistically significant differences existed between the 2 study groups in terms of operative time, duration of hospital stay, or intra- and postoperative complications. At last follow-up, no statistically significant differences existed in Knee Society Scores and Western Ontario and McMaster Universities Arthritis Index scores. Implant alignment and radiological parameters were similar in both groups. This study demonstrated that posttraumatic knee arthritis after prior distal femoral fracture can be safely managed using a computer-assisted TKA without hardware removal. Comparison between the study group and a matched group with atraumatic arthritis showed similar postoperative results and complication rates.
authors.affiliation: First Orthopedic Department, CTO Hospital, Milan, Italy. alf.manzotti@libero.it
authors.forename: Alfonso
authors.initials: A
authors.lastname: Manzotti
authors.forename: Cesare
authors.initials: C
authors.lastname: Chemello
authors.forename: Chris
authors.initials: C
authors.lastname: Pullen
authors.forename: Pietro
authors.initials: P
authors.lastname: Cerveri
authors.forename: Norberto
authors.initials: N
authors.lastname: Confalonieri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D017760:Bone Malalignment / Q000209:etiology; D020878:Device Removal; D005260:Female; D005264:Femoral Fractures / Q000150:complications* / Q000601:surgery; D006304:Health Status; D006801:Humans; D007718:Knee Injuries / Q000150:complications* / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome