One stage total knee arthroplasty with long stemmed tibia for traumatic tibial diaphysis fracture with co-existing osteoarthritis of the knee- a novel technique

Presenting Author - Sanjay B Londhe
Introduction: Tibial upper third and diaphysial fractures in the elderly pose a challenge to an orthopedic surgeon The situation becomes more complex when these fractures are associated with ipsilateral knee OA The traditional way of managing this problem is three stage surgery namely fracture fixation followed by implant removal and then TKR Procedure: We describe a novel technique of a one stage TKR with long stemmed tibia achieving fixation of the fracture and addressing the knee OA Case series three cases of tibial shaft fractures following trauma and co-existing OA were managed with this technique All patients were females and non diabetics Knee ROM and quadriceps strengthening exercises were started immediately post-op AP and Lateral x rays were obtained at 6 and 12 weeks post-op At six weeks patients were mobilized partial weight bearing with a long knee brace and 12 weeks patients were mobilized full weight bearing after confirming union on x ray Implant :All patients received posterior stabilized implant with long stemmed tibia Results: All the three patients were fully mobile with good ROM with their fractures united at 12 weeks. All had excellent parameters on clinical and functional AKSS scores and WOMAC pain and stiffness scores Conclusion: This novel technique offers one stage solution to this complex situation reducing two future hospital admissions /surgeries and associated costs and complications Also it allows faster rehabilitation.