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KMID : 0359620080200010065
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Journal of Korean Knee Society
2008 Volume.20 No. 1 p.65 ~ p.70
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Total Knee Arthroplasty for Salvage of Nonunion of the Distal Femur in Elderly Patients with Osteoarthritis
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Kim Yeung-Jin
Chun Churl-Hong
Yang Hwan-Deok
Kim Tae-Kyun
Kim Hyung-Joon
Shim Sung-Woo
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Abstract
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Purpose: We wanted to evaluate performing total knee arthroplasty for the salvage treatment of nonunion of the distal femoral fracture in elderly patients.
Materials and Methods: From October 2000 to March 2007, 10 patients were treated with total knee arthroplasty for salvage of nonunion of distal femoral fracture. The average age of the patients was 70.3 years (range: 60 to 75). The average follow-up period was 31.9 months (range: 12 to 90). The original fracture site was the supracondylar area in 9 cases and it was distal to the supracondylar area in 1 case. 6 patients had been treated with an anatomical plate, 3 with a Dynamic Condylar Screw and 1 with retrograde nailing. The radiograghs before knee arthroplasty demonstrated degenerative changes in the knee joint in all patients. The following total knee components were used: 7 Legacy Knee-Constrained Condylar (Zimmer) and 3 E-motion (B-Braun). The clinical assessments consisted of radiologic evaluation and the Knee Society knee Score (KSS).
Results: There was no malalignment ＞10° in any plane for the revision operation that was due to nonunion. The mean KSS knee score improved from 23 (range: 10∼31) preoperatively to 81 (range: 68∼89) postoperatively. The mean knee range of motion at the latest follow-up was 3° (range: 0∼10°) to 105° (range: 90∼130°). One patient required nonoperative wound care for marginal wound skin necrosis.
Conclusion: We recommend this treatment modality for nonunion of the distal femoral fracture with coexisting gonarthrosis.
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KEYWORD
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Distal femur, Nonunion, Total knee arthroplasty
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