Post-Traumatic Total Knee Arthroplasty: A Case of Hoffa Fracture Nonunion and Review of Literature

Abstract

Background: Post-traumatic arthroplasty is associated with higher rates of complications and overall inferior outcome when compared with primary joint replacement. Literature revealed no precise guidelines on management of nonunion of Hoffa fracture. Hence, we tried to elicit a management protocol in such patients from literature perspective.

Case Presentation: A 62-year-old patient survived a car accident with distal femoral fracture in coronal plane (Hoffa fracture) and was treated with open reduction and internal fixation (ORIF). Three years later, the patient developed nonunion with post-traumatic arthritis (PTA). Owing to joint degeneration and poor bone quality, patient was treated with total knee arthroplasty (TKA). One year follow-up showed excellent outcome.

Conclusions: In patient with healthy joint surface and good bone density, treatment of choice should be ORIF and in those with joint degeneration and low bone stock, arthroplasty is a better choice.