Total Knee Arthroplasty in post-traumatic intra-articular cases

Total knee arthroplasties is a valuable solution for degenerative osteoarthritis including post-traumatic situations. However, functional results are worse in post-traumatic arthritis compared to pure OA. Difficulties and specific points are intra-articular involvement of initial fracture, leading to bone loss, capsula and ligaments retraction, previous incisions management and wound complications. As patients with post-traumatic knee arthritis are youngers, with more demanding results, subjective results are often moderate. Based on a monocentric study of 15 cases of post-traumatic intra-articular involvement total knee arthroplasty, authors built up a therapeutic algorithm that includes all different criteria surgeons must deal with such as surgical approach choice, articular release, implant choice and additional flap surgery Pain relief is the most positive result at follow-up. Flexion-extension passive range of motion showed an average of 5 degrees of deficit of extension, and an average full flexion of 90 degrees. Average improvement of mobility is over 50%. Usefulness of flap surgery simultaneous to total knee implantation was objective. Results of total knee arthroplasties in post-traumatic osteoarthritis are worse than in degnerative ones. Additional surgical skills are mandatory for an optimal result, such as bone grafts, flap transfer or computer assisted surgery.