ArticleHCA healthcare journal of medicine2025
Utilizing Femoral Metaphyseal Sleeves in Primary Total Knee Arthroplasty for Post-Traumatic Osteoarthritis: A Case Report.
Article in HCA healthcare journal of medicine, 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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Abstract
Background: Total knee arthroplasty in younger patients presents a heightened risk of postoperative complications and implant failures compared to older populations, particularly in those with posttraumatic arthritis. These challenges necessitate careful consideration and specialized approaches to optimize the outcomes in this patient demographic. Case Presentation: A 43-year-old man presented with left knee pain resulting from a traumatic lawn mower injury, causing an intraarticular distal femur, at the age of 6. The injury led to a limb-length discrepancy for which he underwent 2 limb-lengthening procedures in his early 20s. Radiographs demonstrated advanced posttraumatic osteoarthritis, and the patient elected to proceed with surgical intervention. Intraoperatively, significant deficiencies of the medial femur and anterodistal femur were noted, making cement, a bone graft, or a combination of both, less viable options. He underwent a left total knee arthroplasty, with the utilization of a femoral metaphyseal sleeve, due to severe bone loss in the distal femur. Postoperatively, the patient progressed well and returned to his activities of daily living, and, at about 3 months, had a pain-free left knee, without a disturbance of his prior limb-length discrepancy. Conclusion: This is a rare case of a metaphyseal sleeve being used in a younger patient, revealing the potential for this procedure to be used in cases of primary total knee arthroplasty in patients with posttraumatic osteoarthritis.
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