Cruciate-Retaining Stemmed Total Knee Arthroplasty for Supracondylar-Intercondylar Femoral Fractures in Elderly Patients. A Report of Three Cases

The treatment of supracondylar or intercondylar femoral fractures in elderly patients with gonarthrosis is a difficult problem. Primary total knee arthroplasty (TKA) can be considered as a treatment modality for these patients, and several authors have reported acceptable results with this option. They have performed TKA using custom-made, hinged, or constrained components with long stem for fracture reduction and stabilization. But use of hinged or constrained total knee arthroplasties for dealing with supracondylar and intercondylar fractures may be unnecessary, and an alternative is to use a cruciate-retaining stemmed TKA. We report 3 elderly female patients who had supracondylar or intercondylar femoral fractures and coexisting gonarthrosis treated by primary TKA with use of a cruciate-retaining augmentable femoral component with stem extension. All patients improved their ambulatory status and showed good knee function. We believe that use of a cruciate-retaining type of component is a reasonable alternative to the use of a more constrained prosthesis in the treatment for this group of patients.