Abdelaal Ahmed M, Khalifa Ahmed A
Orthopaedic and Traumatology Department, Assiut University Hospital, Assiut 83523, Egypt.
Hospital for Advanced Orthopaedics, Assiut 83523, Egypt.
Reports (MDPI). 2024 Jun 4;7(2):44. doi: 10.3390/reports7020044.
Tibial Periprosthetic fractures (PPF) after primary total knee arthroplasty (TKA) are uncommon and mainly occur after trauma. Various management options have been proposed; however, the decision mainly relies on the location of the fracture and the tibial baseplate stability and ranges between conservative (non-operative), fracture fixation, and revision TKA. We report a case of a 79-year-old female patient who presented with atraumatic lateral tibial plateau PPF (Felix type ⅠB) with a loose tibial implant after three weeks of having left primary TKA. The patient was treated successfully by revising the tibial component using a stemmed tibial baseplate and reconstructing the tibial bone defect using two metal wedges. The radiological, functional, and PROM outcomes were satisfactory and accepted both early on (eight weeks) and at the last follow-up (six months). Atraumatic insufficiency Felix type ⅠB PPF of the lateral tibial plateau after primary TKA is uncommon. Reconstructing the tibial bone defect, revising the tibial component, and adding a stem to offload the tibial plateau are the treatments of choice that lead to acceptable outcomes.
初次全膝关节置换术（TKA）后发生的胫骨假体周围骨折（PPF）并不常见，主要发生于创伤后。已经提出了多种治疗方案；然而，治疗决策主要取决于骨折的位置以及胫骨基板的稳定性，治疗方式包括保守治疗（非手术）、骨折固定和翻修TKA。我们报告一例79岁女性患者，在左膝初次TKA术后三周出现无创伤性的外侧胫骨平台PPF（费利克斯ⅠB型），伴有胫骨假体松动。通过使用带柄胫骨基板翻修胫骨部件，并使用两个金属楔块重建胫骨骨缺损，成功治疗了该患者。放射学、功能和患者报告结局在早期（8周）和最后随访（6个月）时均令人满意且可接受。初次TKA后外侧胫骨平台无创伤性骨不连费利克斯ⅠB型PPF并不常见。重建胫骨骨缺损、翻修胫骨部件并增加柄以减轻胫骨平台负荷是可取得满意疗效的首选治疗方法。
