Complex Total Knee Arthroplasty for Posttraumatic Osteoarthritis: Assessment, Approach, and Outcomes

The incidence of posttraumatic knee osteoarthritis occurs in nearly one-third of patients sustaining intra-articular fracture and/or ligamentous knee injury. As a result, complex total knee arthroplasty may become the best treatment option for these patients. Several challenges must be considered when planning and executing the surgery, including exposure with prior incisions, implant retention or removal, angular deformity, bone defects, stability, and the use of enabling technologies. Although these patients demonstrate notable improvement in pain and function after complex total knee arthroplasty, higher complication rates, increased revision risk, and inferior patient-reported outcomes have also been shown comparatively. This review will summarize how to effectively approach these complicated cases and report contemporary outcomes.