The customized prosthesis for lateral unicompartmental knee arthroplasty in the treatment of malunion of a Hoffa fracture of the distal femur: A case report
Year: 2025
Type: article
Study design: Case Report
Abstract: INTRODUCTION: Postoperative 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. CONCLUSION: Customized 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.
Institutions: Capital Medical University, Beijing Jishuitan Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,090
Awards: G1960717556, G6055610190
OpenAlex ID: W4408975328