Open AccessPost-Traumatic Total Knee Arthroplasty: A Case of Hoffa Fracture Nonunion and Review of Literature
Author(s) -
Seyed Mohammad Javad Mortazavi,
Ahmed Ramezanpour,
Furqan Mohammed Yaseen Khan,
Mohammad Javad Dehghani-Firoozabadi
Publication year - 2020
Publication title -
journal of orthopedics and spine trauma
Language(s) - English
Resource type - Journals
eISSN - 2538-4600
pISSN - 2538-2330
DOI - 10.18502/jost.v4i3.3080
Subject(s) - medicine , nonunion , surgery , internal fixation , arthroplasty , coronal plane , reduction (mathematics) , radiology , geometry , mathematics
Background: Post-traumatic arthroplasty is associated with higher rates of complications and overall inferior outcome when compared with primary joint replacement. Literature revealed no precise guidelines on management of nonunion of Hoffa fracture. Hence, we tried to elicit a management protocol in such patients from literature perspective.
Case Presentation: A 62-year-old patient survived a car accident with distal femoral fracture in coronal plane (Hoffa fracture) and was treated with open reduction and internal fixation (ORIF). Three years later, the patient developed nonunion with post-traumatic arthritis (PTA). Owing to joint degeneration and poor bone quality, patient was treated with total knee arthroplasty (TKA). One year follow-up showed excellent outcome.
Conclusions: In patient with healthy joint surface and good bone density, treatment of choice should be ORIF and in those with joint degeneration and low bone stock, arthroplasty is a better choice.