One-stage total knee arthroplasty for femoral supracondylar fracture combined with knee osteoarthritis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Shangzeng ¹ , WU Shengchao ² , YOU Mingcan ² , LI Qiang ² ,  ZHENG Fuzeng ¹

1. Department of Orthopaedics, the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou Henan, 450002, P.R.China;
2. Postgraduate School, Henan University of Traditional Chinese Medicine, Zhengzhou Henan, 450046, P.R.China;

Corresponding?author：

ZHENG Fuzeng, Email: 469336814@qq.com

Keywords：

Total knee arthroplasty; femoral supracondylar fracture; osteoarthritis; One-stage surgery

DOI：

10.7507/1002-1892.201707071

Video：

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Objective To evaluate the effectiveness of one-stage total knee arthroplasty (TKA) for femoral supracondylar fracture combined with knee osteoarthritis. Methods Between January 2012 and March 2015, a total of 19 patients (19 knees) with femoral supracondylar fracture and knee osteoarthritis were treated with one-stage TKA. Of 19 cases, 8 were male and 11 were female with an average age of 69.6 years (range, 60-85 years). The mean body mass index was 22.6 kg/m² (range, 22.0-27.5 kg/m²). The left knee was involved in 13 cases, and the right knee in 6 cases. The causes of femoral supracondylar fracture were falls in 10 cases, traffic accidents in 8 cases, and other injury in 1 case. All fractures were classified as type A according to AO/Association for the Study of Internal Fixation (AO/ASIF) classification. The interval of injury and operation was 4-13 days (mean, 8.6 days). The disease duration of osteoarthritis ranged from 30 to 90 months (mean, 52.6 months). During follow-up, the knee society score (KSS) and the range of motion (ROM) were used to evaluate the knee function; anteroposterior and lateral X-ray films of the knee were used to observe the position of the prosthesis. Results All the incisions healed at the first stage, and there was no early complication such as pulmonary infection, pressure ulcer, and urinary tract infection. All patients were followed up 2-4 years with an average of 2.6 years. The ROM and KSS functional scores and clinical scores were significantly improved at 15 days and 2 years after operation, showing significant differences when compared with those before operation (P<0.05). There were significant differences in the ROM and KSS functional scores and clinical scores between two time points after operation (P<0.05). X-ray films showed the fracture bone healing, good alignment, no loosening of prosthesis at 2 years after operarion. Conclusion One-stage TKA for femoral supracondylar fracture combined with knee osteoarthritis can achieve good effectiveness. It can not only reconstruct joint function, but also cure osteoarthritis and fracture at the same time, shorten the healing time, reduce the incidence of related complications.

Citation： WANG Shangzeng, WU Shengchao, YOU Mingcan, LI Qiang, ZHENG Fuzeng. One-stage total knee arthroplasty for femoral supracondylar fracture combined with knee osteoarthritis. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(12): 1423-1427. doi: 10.7507/1002-1892.201707071 Copy

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11.	金京日, 任紅革, 劉彥群, 等. 膝前切口經髕骨縱行截骨入路治療股骨遠端C型骨折的療效分析. 中國修復重建外科雜志, 2015, 29(6): 700-703.
12.	Erhardt JB, Vincenti M, Pressmar J, et al. Mid term results of distal femoral fractures treated with a polyaxial locking plate: a multi-center study. Open Orthop J, 2014, 8(1): 34-40.
13.	牛子全, 李淑琴, 姚勇, 等. 外側鎖定鋼板結合植骨治療老年股骨遠端骨折. 中華創傷骨科雜志, 2016, 18(2): 166-168.
14.	茹江英, 時代, 魯揚虎, 等. 附加鎖定加壓鋼板與微創穩定系統聯合自體骨植骨治療逆行髓內釘術后股骨遠端骨不連的對比分析. 中華臨床醫師雜志(電子版), 2016, 10(17): 2564-2570.
15.	蘭平文, 沈彬. 全膝關節置換術后假體周圍骨折的診療進展. 中華關節外科雜志(電子版), 2013, 7(2): 240-244.
16.	宋金輝, 張二洋, 張晨, 等. 全膝關節置換術后股骨髁上骨折的治療12例報告. 中國骨與關節雜志, 2016, 5(10): 739-742.
17.	郭志民, 龔星星, 李延煒, 等. 解剖型鋼板結合異體皮質骨板治療股骨髁粉碎性骨折. 中國修復重建外科雜志, 2015, 29(1): 6-9.

1. 姜保國, 王滿宜. 關節周圍骨折. 北京: 人民衛生出版社, 2013: 408-415.
2. 胥少汀, 葛寶豐, 徐印坎. 實用骨科學. 4 版. 北京: 人民軍醫出版社, 2012: 983-999.
3. Smith JR, Halliday R, Aquilina AL, et al. Distal femoral fractures: The need to review the standard of care. Injury, 2015, 46(6): 1084.
4. Virk JS, Garg SK, Gupta P, et al. Distal femur locking plate: the answer to all distal femoral fractures. J Clin Diagn Res, 2016, 10(10): RC01-RC05.
5. Marsh JL, Slongo TF, Agel J, et al. Fracture and dislocation classification compendium-2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma, 2007, 21(10 Suppl): S1-133.
6. 虞驚濤, 茹選良. 股骨遠端骨折的處理方法. 中華關節外科雜志(電子版), 2015, 9(5): 663-666.
7. Eskelinen EV, Liska WD, HK Hyyti?inen HK, et al. Canine total knee replacement performed due to osteoarthritis subsequent to distal femur fracture osteosynthesis: two-year objective outcome. Vet Comp Orthop Traumatol, 2012, 25(5): 427-432.
8. 張曉強, 高菲菲, 段小波. 人工膝關節表面置換術在股骨髁上骨折合并膝關節骨性關節炎中的應用. 中國實用醫藥, 2014, 9(17): 52-53.
9. Atrey A, Hussain N, Gosling O, et al. A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures-An alternative treatment option. J Orthop, 2017, 14(1): 216-222.
10. 任姜棟, 張曉崗, 曹力, 等. 一期全膝關節置換治療陳舊性股骨髁骨折合并膝關節骨關節炎. 中華骨科雜志, 2012, 32(9): 843-848.
11. 金京日, 任紅革, 劉彥群, 等. 膝前切口經髕骨縱行截骨入路治療股骨遠端C型骨折的療效分析. 中國修復重建外科雜志, 2015, 29(6): 700-703.
12. Erhardt JB, Vincenti M, Pressmar J, et al. Mid term results of distal femoral fractures treated with a polyaxial locking plate: a multi-center study. Open Orthop J, 2014, 8(1): 34-40.
13. 牛子全, 李淑琴, 姚勇, 等. 外側鎖定鋼板結合植骨治療老年股骨遠端骨折. 中華創傷骨科雜志, 2016, 18(2): 166-168.
14. 茹江英, 時代, 魯揚虎, 等. 附加鎖定加壓鋼板與微創穩定系統聯合自體骨植骨治療逆行髓內釘術后股骨遠端骨不連的對比分析. 中華臨床醫師雜志(電子版), 2016, 10(17): 2564-2570.
15. 蘭平文, 沈彬. 全膝關節置換術后假體周圍骨折的診療進展. 中華關節外科雜志(電子版), 2013, 7(2): 240-244.
16. 宋金輝, 張二洋, 張晨, 等. 全膝關節置換術后股骨髁上骨折的治療12例報告. 中國骨與關節雜志, 2016, 5(10): 739-742.
17. 郭志民, 龔星星, 李延煒, 等. 解剖型鋼板結合異體皮質骨板治療股骨髁粉碎性骨折. 中國修復重建外科雜志, 2015, 29(1): 6-9.

Chinese Journal of Reparative and Reconstructive Surgery

One-stage total knee arthroplasty for femoral supracondylar fracture combined with knee osteoarthritis

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