The customized prosthesis for lateral unicompartmental knee arthroplasty in the treatment of malunion of a Hoffa fracture of the distal femur: A case report.

Cunxiang Ma, Qing Liu, Hangyu Gu, Teng Zhang, Junqiang Wang, Wei Han

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Article in International journal of surgery case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Cunxiang MaDepartment of Orthopaedic Trauma, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China; Seventh Clinical Medical College of Capital Medical University, Beijing, China.

Qing LiuDepartment of Knee Preservation Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.

Hangyu GuDepartment of Orthopaedic Trauma, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China; Seventh Clinical Medical College of Capital Medical University, Beijing, China.

Teng ZhangDepartment of Orthopaedic Trauma, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China; Beijing Jishuitan Orthopaedic Robot Engineering Research Center Co., LTD, Beijing, China.

Junqiang WangDepartment of Orthopaedic Trauma, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China; Beijing Jishuitan Orthopaedic Robot Engineering Research Center Co., LTD, Beijing, China.

Wei HanDepartment of Orthopaedic Trauma, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China; Seventh Clinical Medical College of Capital Medical University, Beijing, China; Beijing Jishuitan Orthopaedic Robot Engineering Research Center Co., LTD, Beijing, China. Electronic address: hanweijst@163.com.

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6 · The paper itself

Abstract

introductionPostoperative malunion following distal femoral Hoffa fractures is rare yet challenging. We present a novel approach using customized lateral unicompartmental knee arthroplasty (UKA) to address malunion with traumatic osteoarthritis, emphasizing functional restoration. CASE PRESENTATION: A 52-year-old male presented with persistent right knee pain (VAS score: 7/10), restricted range of motion (ROM: 0°-60° flexion), and gait instability two years after open reduction and internal fixation (ORIF) of a lateral Hoffa fracture. Imaging confirmed malunion of the fracture with traumatic osteoarthritis. A customized lateral femoral condyle prosthesis was designed using three-dimensional Computed Tomography (CT) reconstruction and implanted via a lateral parapatellar approach. Postoperative imaging (8-12 weeks) revealed optimal alignment and resolved fracture gaps. At 12 weeks, pain resolved (VAS: 1/10), ROM improved to 0°-125°, and Knee Society Score reached 85/100, with no complications. CLINICAL DISCUSSION: Malunion after Hoffa fracture fixation is uncommon. Traditional revision ORIF may fail due to bone loss, while UKA preserves healthy compartments by restoring biomechanics. Customized implants address anatomical complexity, though long-term efficacy requires further study.

conclusionCustomized UKA offers a viable solution for Hoffa fracture malunion with traumatic osteoarthritis, prioritizing joint preservation. This approach highlights the potential of patient-specific implants in complex orthopaedic salvage.

Indexed as

Case reportCustomized prosthesisHoffa fractureMalunionUnicompartmental knee arthroplasty

Identifiers

PMID40157064

DOI10.1016/j.ijscr.2025.111231

PMCPMC11994342

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