A case of total knee replacement in a patient with osteoarthritis of knee joint with malunited distal femur fracture with stiffness

Abstract

Introduction: Distal Femoral fracture may lead to the development of post-traumatic arthrosis of knee joint because of direct intraarticular injury. Malunion of distal femur fracture, intra-articular osseous defects, limb malalignment and compromised surrounding soft tissues may in turn affect the outcome of total knee arthroplasty (TKA) and makes it a technically demanding surgery. Here we report our experience regarding this complex knee arthroplasty.Case presentation: We report a case of 72 year old male patient who presented with progressive left knee pain and limited range of motion of left knee joint. Patient had a history of trauma 3 years back which is treated conservatively. Preoperative radiograph indicates severe osteoarthritis of tibiofemoral and patellofemoral joint with multiple osteophytes and malunited distal femur fracture, for which he was treated with primary total knee replacement, which showed good clinical and functional outcome at the end of 6 months.Conclusion: Total knee arthroplasty in patient with malunited distal femur is technically challenging and can require skills, good preoperative planning, templating and good soft tissue balancing. In patients with malunited distal femur, where optimal limb and implant alignment are achieved, results are much more promising and can compete with the results seen with routine primary knee replacement.