Management of Tibial and Femoral Non-unions and Stress Fractures with Severe Ipsilateral Knee Arthritis with Long Stemmed Modular Total Knee Arthroplasty


Management of patients with non-unions or stress fractures of the tibia or distal femur with debilitating ipsilateral knee arthritis can be diffi cult to manage. In these examples of care, we present three illustrations of using long stemmed modular total knee components to successfully manage both tibial and femoral non-unions and stress fractures as well as ipsilateral arthritis with resultant deformity. The average improvement in our knee outcome scores for these three patients via preoperative Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) and one-year post-operative KOOS, JR is 44.37. After treatment with a long stemmed modular total knee prosthesis all three examples of care went on to union and the arthritic deformity was corrected. (Journal of Surgical Orthopaedic Advances 31(3):166–168, 2022)

Key words: total joint, arthroplasty, revision total knee, adult reconstruction, stress fracture, non-union

James Aitken, DO; Emily Sparks; and John Shields, MD