Management of Tibial stress fracture in Osteoarthritic deformed Knee with Total Knee Arthroplasty

Abstract:Stress fractures of the tibia which occurs due to the osteoarthritic deformities are rare and pose a
great challenge in management. We managed three such patients with stress fractures of proximal tibia with
deformed osteoarthritic knee. All patients had established osteoarthritis of the knee; one patient with genu
valgus deformity and the other two with genu varus deformity. All of them underwent a total knee replacement
with a long tibial stem extension, and subsequently, their fractures united on followup. All three patients
recovered uneventfully with good functional range of movements restored. Correction of extra –articular
deformities with the restoration of normal knee mechanics and joint lines along with reduction of tension
stresses on the bone and stabilisation of the associated stress fractures and replacement of the arthritic joints
can all be done effectively with long stemmed modular total knee arthroplasty implants.