Early Primary Total Knee Arthroplasty in Fractures Around The Knee – Malaysia District Hospital Experience

Abstract

Introduction: Treatment of comminuted intra-articular fractures around the knee in the elderly population could be challenging. Factors such as pre-existing comorbidities, osteoporosis, cartilage damage and deformity could make fracture reduction difficult. Patients outcome is guarded due to risk of delayed or non-union, delayed weight bearing and prolonged rehabilitation phase. Methods: We present a retrospective study on 12 patients who underwent early primary total knee replacement after sustaining intra-articular fracture around the knee from 2017 to 2019. Legacy Constrained Condylar Knee (LCCK) were used and patients were follow-up at 3, 6 and 12 months. Results: Mean follow-up period is 14 months. All except one patient received Posterior Stabilized insert while other patients had LCCK. Two patients were complicated with prosthetic joint infection requiring debridement and revision surgery. The remaining patients achieved full knee extension and average flexion of 100 degrees. Conclusion: Early knee arthroplasty is able to achieve excellent short-term outcome in treatment of comminuted intra-articular fractures around the knee in elderly patients.