This study aims to determine the rate of and risk factors for total knee arthroplasty (TKA) after operative management of tibial plateau fractures (TPFs) in older adults. This is a retrospective cohort study of 182 displaced TPFs in 180 patients aged ≥ 60 years, over a 12-year period with a minimum follow-up of one year. The mean age was 70.7 years (SD 7.7; 60 to 89), and 139/180 patients (77.2%) were female. Radiological assessment consisted of fracture classification; pre-existing knee osteoarthritis (OA); reduction quality; loss of reduction; and post-traumatic OA. Fracture depression was measured on CT, and the volume of defect estimated as half an oblate spheroid. Operative management, complications, reoperations, and mortality were recorded.Aims
Methods
We investigated the extent to which improved
balance relative to pain relief correlates with the success of total knee
replacement (TKR). A total of 81 patients were recruited to the
study: 16 men (19.8%) and 65 women (80.2%). Of these, 62 patients
(10 men, 52 women) with a mean age of 73 (57 to 83) underwent static
and dynamic assessment of balance pre-operatively and one year post-operatively.
The parameters of balance were quantified using commercially available
and validated equipment. Motor function and self-reported outcome
were also assessed. There was a significant improvement in dynamic balance (p <
0.001) one year after TKR, and better balance correlated with improved
mobility, functional balance and increased health-related quality
of life. As it seems that balance, and not only pain relief, influences
the success of TKR, balance skills should be better addressed during
the post-operative rehabilitation of patients who undergo TKR.
The lateral compartment is predominantly affected
in approximately 10% of patients with osteoarthritis of the knee. The
anatomy, kinematics and loading during movement differ considerably
between medial and lateral compartments of the knee. This in the
main explains the relative protection of the lateral compartment
compared with the medial compartment in the development of osteoarthritis.
The aetiology of lateral compartment osteoarthritis can be idiopathic,
usually affecting the femur, or secondary to trauma commonly affecting
the tibia. Surgical management of lateral compartment osteoarthritis
can include osteotomy, unicompartmental knee replacement and total
knee replacement. This review discusses the biomechanics, pathogenesis
and development of lateral compartment osteoarthritis and its management. Cite this article:
