Considerations with osteoporosis, preexisting arthritis, and significant articular injury

Considerations with osteoporosis, preexisting arthritis, and significant articular injury

In elderly patients with osteoarthritis of the knee, it may be inappropriate to attempt fracture fixation. This is a rare situation. It may be better to consider primary joint replacement with the assistance of a specialist knee arthroplasty surgeon. However, it must be recognized that, because of the supracondylar component of the fracture, the result of such a total knee arthroplasty would be significantly worse than an elective primary knee arthroplasty. It may be necessary to use a complex knee prosthesis, such as those with rotating hinges. In very difficult such distal femoral fractures, mega-prosthesis may be required.

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