Stemmed Knee Replacement in a Patient With an Irremovable Tibial Nail


A patient with a cemented centrally located intramedullary tibial nail that occluded the proximal tibial canal underwent knee reconstruction with a total knee design utilizing a custom hollow tibial stem. In this oncology case, a rotating-hinge knee design was used that incorporates an intra-articular inverted postin-channel central rotational post design. This design allowed for a rather straightforward reconstruction that functioned well for 3 years. Although rarely encountered, utilization of a hollow-stemmed tibial total knee component may allow salvage of an extremity with central occlusion of the proximal tibial canal. (Journal of Surgical Orthopaedic Advances 22(3):237–240, 2013)

William G. Ward, Sr., MD, and Joshua M. Cooper, MD