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Tibial plateau fractures (TPFs) are common and difficult-to-manage injuries that can be due to high- or low-energy trauma and can affect young adults or third-age patients. When faced with one of these injuries there are some questions to be
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meta-diaphyseal or diaphyseal tibial or femoral fracture healing with a limb deformity, which leads to chronic abnormal stress on articular surfaces and subsequent cartilage degeneration. Post-traumatic arthritis is a relatively common problem for the
Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
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Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain
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bone defect and soft tissue in the same stage, with good results ( 88 ). Malunion Collapse or irregularity of the articular surface or deformity of the metaphyseal–diaphyseal junction after surgical treatment of tibial plateau fractures can
Personalized Arthroplasty Society, Atlanta, Georgia, USA
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Nuffield Orthopaedic Centre, Headington, Oxford, UK
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Personalized Arthroplasty Society, Atlanta, Georgia, USA
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South-West London Elective Orthopaedic Centre, Epsom, UK
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Shamir Medical Center, Zriffin, Israel
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Département de Chirurgie, Université de Montréal, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada
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joint line orientation (severe frontal joint line obliquity, high tibial posterior slope) Patella maltracking Difficulty in estimating native knee anatomy (mainly articular bone loss) Acquired lower limb malalignment from previous fracture malunion
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fractures. The fragment is reattached with wires passed behind the tibial stem and fixation is usually reinforced with medullary screws. These also avoid proximo-distal migration with subsequent de-tension of the cerclage wiring. If the dimensions of the
Personalized Arthroplasty Society, Atlanta, Georgia, USA
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Personalized Arthroplasty Society, Atlanta, Georgia, USA
Clinique Orthopédique Duval, Laval, Quebec, Canada
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Personalized Arthroplasty Society, Atlanta, Georgia, USA
Clinique Orthopédique Duval, Laval, Quebec, Canada
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Department of Knee Surgery, Casa di Cura Solatrix, Rovereto, TN, Italy
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Personalized Arthroplasty Society, Atlanta, Georgia, USA
Clinique Orthopédique Duval, Laval, Quebec, Canada
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with previous high tibial osteotomy and sequelae of a diaphyseal tibial fracture. (A) Tibia has an extra-articular valgus deformity. (B) Post-operative radiographs where the extra-articular deformities were addressed with intra-articular tibial cut
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-ROM Noiles (Joint Medical Products/Johnson and Johnson) (1) 3 months Revision was performed to insert a custom tibial tray containing a full-length central metallic reinforcing post The polyethylene post fractured at the inferior tip of the central
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variable diaphyseal fixation depending on the type of pathology and its extent. A similar surgical indication is the treatment of periprosthetic fractures in older patients. There is a renewal of interest in this type of implant in TKA revision surgery
Osteoarticular Surgery Research, La Paz Hospital Health Research Institute – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain
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Longer stems cause tibial pain at the end of the stem in up to 10% of patients, and an off-setting might be required if diaphyseal engagement results in malalignment or a higher risk of fracture, 32 – 35 which is why cementless stems are preferred if
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remove, however, and may increase stress-shielding in the surrounding bone. Press-fit diaphyseal stems with cement in the metaphyseal portion of the implant have also been used. 38 Structural integrity of both the femoral and tibial canals is
