Journal of orthopaedic case reports · 2026
Megaprosthetic Total Knee Arthroplasty for Supracondylar Refracture in a Post-traumatic Osteoarthritic Knee: A Case Report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Takai Hirokazu, Hirata Kengo, Tahara Kentaro, Kudo Yuki, Nakamura Ryo, Takahashi Tomoki
Аннотация
INTRODUCTION: Supracondylar femoral refracture in the setting of post-traumatic osteoarthritis presents a complex reconstructive challenge, particularly when prior fracture healing is incomplete and knee function is severely compromised. In such cases, conventional fixation or standard total knee arthroplasty may be associated with a high risk of failure and poor functional recovery.
CASE REPORT: A 77-year-old man with a remote history of distal femoral fracture, including a Hoffa fracture, presented with chronic pain, severe stiffness, and marked functional limitation. Following a fall, he sustained a supracondylar refracture. Radiographs and pre-operative computed tomography demonstrated advanced post-traumatic osteoarthritis, partial non-union, dense sclerosis, loss of normal cancellous architecture, and chronic distal femoral deformity. Despite apparently preserved bone stock on plain radiographs, these findings suggested poor biological healing potential. Intraoperatively, minimal bleeding from the distal femoral bone further supported severe biological compromise. Given the high risk of failed union with further internal fixation, persistent non-union, and poor functional recovery, one-stage distal femoral replacement using a megaprosthesis was performed. The patient achieved uneventful recovery with improved pain, range of motion, and ambulation.
CONCLUSION: Megaprosthetic reconstruction represents a rational salvage option for supracondylar femoral refracture in biologically compromised post-traumatic knees. Surgical decision-making should prioritize biological viability and realistic functional restoration rather than radiographic bone appearance alone.
CASE REPORT: A 77-year-old man with a remote history of distal femoral fracture, including a Hoffa fracture, presented with chronic pain, severe stiffness, and marked functional limitation. Following a fall, he sustained a supracondylar refracture. Radiographs and pre-operative computed tomography demonstrated advanced post-traumatic osteoarthritis, partial non-union, dense sclerosis, loss of normal cancellous architecture, and chronic distal femoral deformity. Despite apparently preserved bone stock on plain radiographs, these findings suggested poor biological healing potential. Intraoperatively, minimal bleeding from the distal femoral bone further supported severe biological compromise. Given the high risk of failed union with further internal fixation, persistent non-union, and poor functional recovery, one-stage distal femoral replacement using a megaprosthesis was performed. The patient achieved uneventful recovery with improved pain, range of motion, and ambulation.
CONCLUSION: Megaprosthetic reconstruction represents a rational salvage option for supracondylar femoral refracture in biologically compromised post-traumatic knees. Surgical decision-making should prioritize biological viability and realistic functional restoration rather than radiographic bone appearance alone.