Long- Stem Total Knee Arthroplasty for Proximal Tibial Stress Fractures in the Elderly Patients | ||
| The Archives of Bone and Joint Surgery | ||
| مقاله 7، دوره 6، شماره 5، آذر 2018، صفحه 376-380 اصل مقاله (579.8 K) | ||
| نوع مقاله: RESEARCH PAPER | ||
| شناسه دیجیتال (DOI): 10.22038/abjs.2017.25955.1698 | ||
| نویسندگان | ||
| Mahmoud Jabalameli1؛ Hosseinali A. Hadi1؛ Abolfazl Bagherifard1؛ Mohammad Rahbar1؛ Mohammadreza Minator Sajjadi* 2 | ||
| 1Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran | ||
| 2Taleghani Hospital Research Development Unit, Shahid Beheshti University of Medical Sciences, Tehran, Iran | ||
| چکیده | ||
| Background: Presentation of proximal tibia stress fracture is not infrequent among elderly patients due to their poor bone stock. Optimal management of patients with severe gonarthrosis of the knee and concurrent tibial stress fracture is not known yet. In this study we report the outcome of primary total knee arthroplasty (TKA) using stemmed components in elderly patients. Methods: Between 2009 and 2014, a total of 16 elderly patients with proximal tibial stress fractures and concurrent gonarthrosis were treated with TKA using long stemmed components. The diagnosis of stress fractures was confirmed based on the radiographic changes. A standing alignment view was obtained for all patients preoperatively. Union of the fracture site was investigated using plain anteroposterior (AP) and lateral leg x-rays. Results: All patients experienced significant relieve of symptoms. The Knee Society score and Knee Society functional score averaged 86±4 and 85±6, respectively. The mean arc of motion of the knee was 118°±2° at the latest follow-up. All stress fractures resolved at a mean of 8.3±1.1 weeks. The medial proximal tibial angle was increased from 74.7°±5.7° preoperatively to 90.3°±1.1° (P<0.05) postoperatively. Tegner activity scale was increased from 2.1±1.3 to 3.4±0.9 (P<0.05). Conclusion: According to our findings, patients with stress fracture of proximal tibia and concurrent gonarthrosis can be treated with primary TKA using stemmed components that may bypass the stress fracture and allow healing of the fracture. Level of evidence: IV | ||
| کلیدواژهها | ||
| KNEE ARTHROPLASTY FOR PROXIMAL TIBIAL STRESS FRACTURE | ||
| مراجع | ||
|
1. Pommering TL, Kluchurosky L. Overuse injuries in adolescents. Adolesc Med State Art Rev. 2007; 18(1):95-120. 2. Papagelopoulos PJ, Karachalios T, Themistocleous GS, Papadopoulos EC, Savvidou OD, Rand JA. Total knee arthroplasty in patients with pre-existing fracture deformity. Orthopedics. 2007; 30(5):5373-8. 3. Satku K, Kumar VP, Pho RW. Stress fractures of the tibia in osteoarthritis of the knee. J Bone Joint Surg Br. 1987; 69(2):309-11. 4. Haspl M, Jeli´c M, Pe´cina M. Arthroplasty in treating knee osteoarthritis and proximal tibia stress fracture. Acta Chir Orthop Traumatol Cech. 2003; 70(5):303-5. 5. Kopacz J, Warda E, Mazurkiewicz T. Stress fractures of the tibia in elderly women. Chir Narzadow Ruchu Orthop Pol. 2002; 67(5):515-20. 6. Young A, Kinsella P, Boland P. Stress fractures of the lower limb in patients with rheumatoid arthritis. J Bone Joint Surg Br. 1981; 63-B(2):239-43. 7. Akamatsu Y, Mitsugi N, Hayashi T, Kobayashi H, Saito T. Low bone mineral density is associated with the onset of spontaneous osteonecrosis of the knee. Acta Orthop. 2012; 83(3):249-55. 8. Parvizi J, Klein GR, Sim FH. Surgical management of Paget disease of bone. J Bone Miner Res. 2007; 21(2):75-82. 9. Parvizi J, Frankle MA, Tiegs RD, Sim FH. Corrective osteotomy for deformity in Paget disease. J Bone Joint Surgery Am. 2003; 85-A(4):697-702. 10. Sarzaeem MM, Jabalameli M. Stress fracture of the lateral femoral condyle after total knee arthroplasty. Arch Bone Jt Surg. 2017; 5(2):125-8. 11. Patel DS, Roth M, Kapil N. Stress fractures: diagnosis, treatment, and prevention. Am Fam Physician. 2011; 83(1):39-46. 12. Moran DS, Evans RK, Hadad E. Imaging of lower extremity stress fracture injuries. Sports Med. 2008; 38(4):345-56. 13. Sterling JC, Edelstein DW, Calvo RD, Webb R 2nd. Stress fractures in the athlete. Diagnosis and management. Sports Med. 1992; 14(5):336-46. 14. Arendt E, Agel J, Heikes C, Griffiths H. Stress injuries to bone in college athletes: a retrospective review of experience at a single institution. Am J Sports Med. 2003; 31(6):959-68. 15. Varner KE, Younas SA, Lintner DM, Marymont JV. Chronic anterior midtibial stress fractures in athletes treated with reamed intramedullary nailing. Am J Sports Med. 2005; 33(7):1071-6. 16. Sourlas I, Papachristou G, Pilichou A, Giannoudis PV, Efstathopoulos N, Nikolaou SA. Proximal tibial stress fractures associated with primary degenerative knee osteoarthritis. Am J Orthop. 2009; 38(3):120-4. 17. Mittal A, Bhosale PB, Suryawanshi AV, Purohit S. Onestage long-stem total knee arthroplasty for arthritic knees with stress fractures. J Orthop Surg. 2013; 21(2):199-203. 18. Larsson S. Treatment of osteoporotic fractures. Scand J Surg. 2006; 95(2):111-8. 19. Sawant MR, Bendall P, Kavanagh TG, Citron ND. Nonunion of tibial stress fractures in patients with deformed arthritic knees. J Bone Joint Surg Br. 1999; 81(4):663-6. 20. Orava S, Karpakka J, Hulkko A, Väänänen K, Takala T, Kallinen M, et al. Diagnosis and treatment of stress fractures located at the mid-tibial shaft in athletes. Int J Sports Med. 1991; 12(4):419-22. 21. Chen WM, Huang CK, Chen TH, Chiang CC, Lo WH. Bilateral proximal tibial stress fractures in osteoarthritic knee treated with simultaneous corrective osteotomy and internal fixation. J Chin Med Assoc. 2004; 67(1):48-50. | ||
|
آمار تعداد مشاهده مقاله: 594 تعداد دریافت فایل اصل مقاله: 813 |
||