Robotic-Assisted Total Knee Arthroplasty for Distal Femur Fracture with Lateral Knee Osteoarthritis
Introduction. Open reduction and internal fixation (ORIF) of compound fractures around the knee in elderly patient raise concerns about long-term postoperative external fixation and complications. Total knee arthroplasty (TKA) has been proposed as an alternative solution. We report a case where robo...
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| Format: | Article |
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Wiley
2021-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2021/5576955 |
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| author | Takao Kaneko Tadashi Igarashi Shu Yoshizawa Kazutaka Takada Hiroyasu Ikegami Yoshiro Musha |
| author_facet | Takao Kaneko Tadashi Igarashi Shu Yoshizawa Kazutaka Takada Hiroyasu Ikegami Yoshiro Musha |
| author_sort | Takao Kaneko |
| collection | DOAJ |
| description | Introduction. Open reduction and internal fixation (ORIF) of compound fractures around the knee in elderly patient raise concerns about long-term postoperative external fixation and complications. Total knee arthroplasty (TKA) has been proposed as an alternative solution. We report a case where robotic-assisted (RA) TKA was used to treat lateral knee osteoarthritis (OA) with distal femur fracture. Case Presentation. A 90-year-old female visited our hospital with complications of sustained knee pain after a fall at home. Fracture line from the trochlea to the intercondylar notch was diagnosed on plain radiographs, and prior to this injury, the patient was receiving conservative treatment for lateral OA. We selected a conventional TKA over ORIF because the latter is associated with residual pain and the need for long-term immobilization, which can lead to other complications. However, the fracture site was the entry point for intramedullary rod, and there was concern that the fracture site would be displaced by conventional TKA. Therefore, the unique aspect of the case is that the technique utilized involved robotic milling using the Navio system while temporarily stabilizing the fracture using two tracker pins. RA TKA could determine osteotomy and implant placement by predicting the postoperative patient’s soft tissue balance for no medial loosening and lateral contracture. The arthritic cartilage and bone were then methodically removed using the handheld sculptor. After immobilizing the fracture site with a bone grasper before removing the pin tracker, reaming of the femur and insertion of a stem prosthesis with semiconstrained were performed. Primary RA TKA is a viable option for intra-articular fractures in elderly patients with advanced knee osteoarthritis. |
| format | Article |
| id | doaj-art-02f5c8ed26224872b197376a71050d6e |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-02f5c8ed26224872b197376a71050d6e2025-02-03T06:06:31ZengWileyCase Reports in Orthopedics2090-67492090-67572021-01-01202110.1155/2021/55769555576955Robotic-Assisted Total Knee Arthroplasty for Distal Femur Fracture with Lateral Knee OsteoarthritisTakao Kaneko0Tadashi Igarashi1Shu Yoshizawa2Kazutaka Takada3Hiroyasu Ikegami4Yoshiro Musha5Ichinomiya Onsen Hospital, Adult Reconstruction Center, JapanIchinomiya Onsen Hospital, Adult Reconstruction Center, JapanDepartment of Orthopedic Surgery, Toho University School of Medicine, JapanDepartment of Orthopedic Surgery, Toho University School of Medicine, JapanDepartment of Orthopedic Surgery, Toho University School of Medicine, JapanDepartment of Orthopedic Surgery, Toho University School of Medicine, JapanIntroduction. Open reduction and internal fixation (ORIF) of compound fractures around the knee in elderly patient raise concerns about long-term postoperative external fixation and complications. Total knee arthroplasty (TKA) has been proposed as an alternative solution. We report a case where robotic-assisted (RA) TKA was used to treat lateral knee osteoarthritis (OA) with distal femur fracture. Case Presentation. A 90-year-old female visited our hospital with complications of sustained knee pain after a fall at home. Fracture line from the trochlea to the intercondylar notch was diagnosed on plain radiographs, and prior to this injury, the patient was receiving conservative treatment for lateral OA. We selected a conventional TKA over ORIF because the latter is associated with residual pain and the need for long-term immobilization, which can lead to other complications. However, the fracture site was the entry point for intramedullary rod, and there was concern that the fracture site would be displaced by conventional TKA. Therefore, the unique aspect of the case is that the technique utilized involved robotic milling using the Navio system while temporarily stabilizing the fracture using two tracker pins. RA TKA could determine osteotomy and implant placement by predicting the postoperative patient’s soft tissue balance for no medial loosening and lateral contracture. The arthritic cartilage and bone were then methodically removed using the handheld sculptor. After immobilizing the fracture site with a bone grasper before removing the pin tracker, reaming of the femur and insertion of a stem prosthesis with semiconstrained were performed. Primary RA TKA is a viable option for intra-articular fractures in elderly patients with advanced knee osteoarthritis.http://dx.doi.org/10.1155/2021/5576955 |
| spellingShingle | Takao Kaneko Tadashi Igarashi Shu Yoshizawa Kazutaka Takada Hiroyasu Ikegami Yoshiro Musha Robotic-Assisted Total Knee Arthroplasty for Distal Femur Fracture with Lateral Knee Osteoarthritis Case Reports in Orthopedics |
| title | Robotic-Assisted Total Knee Arthroplasty for Distal Femur Fracture with Lateral Knee Osteoarthritis |
| title_full | Robotic-Assisted Total Knee Arthroplasty for Distal Femur Fracture with Lateral Knee Osteoarthritis |
| title_fullStr | Robotic-Assisted Total Knee Arthroplasty for Distal Femur Fracture with Lateral Knee Osteoarthritis |
| title_full_unstemmed | Robotic-Assisted Total Knee Arthroplasty for Distal Femur Fracture with Lateral Knee Osteoarthritis |
| title_short | Robotic-Assisted Total Knee Arthroplasty for Distal Femur Fracture with Lateral Knee Osteoarthritis |
| title_sort | robotic assisted total knee arthroplasty for distal femur fracture with lateral knee osteoarthritis |
| url | http://dx.doi.org/10.1155/2021/5576955 |
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