Total knee arthroplasty for post-traumatic arthrosis

The outcomes of total knee arthroplasty for post-traumatic arthrosis were s tudied in 31 knees. The average age at arthroplasty was 60 years old (range , 36-78 years). The interval from fracture to total knee arthroplasty avera ged 13 years. Simultaneous corrective osteotomy was necessary in 4 patients to correct axial alignment and preserve ligamentous integrity. Follow-up a veraged 46 months. Mean are of motion increased significantly, from 94 degr ees to 100 degrees (P =.027). Average function score improved from 44 to 72 points. This change was statistically significant (P <.0001). Knee Society knee scores also improved significantly, from 36 to 78 points (P <.0001). At most recent follow-up, the functional scores were considered excellent o r good in 58%; knee scores were considered excellent or good in 71% of case s. All periarticular osteotomies and tibial tubercle osteotomies healed une ventfully within 16 weeks. Complications occurred in 57% of cases, includin g aseptic failure (26%), septic failure (10%), patellar tendon rupture (3%) , patellar subluxation (6%), thromboembolism (6%), and wound breakdown requ iring debridement and muscle flap coverage (6%). Despite significant improv ements in motion and function, patients with post-traumatic arthrosis are s usceptible to high rates of complications. Adverse outcomes can be minimize d by restoring limb alignment, soft tissue balance, and component alignment and by preserving vascularity of the skin and subcutaneous tissues.