Total knee arthroplasty in the management of proximal tibial pseudoarthrosis below an osteoarthritic knee

Proximal tibial stress fractures below an osteoarthritic knee represents a confounding situation, with a greater risk of delayed union or nonunion. Conservative treatment results in failure unless an early diagnosis is established. Internal fixation, on the other hand, usually results in union, leaving behind a malaligned and painful arthritic joint. A seventy-year-old woman presenting with an ununited proximal tibial stress fracture below an osteoarthritic knee was treated with total knee prosthesis with a long tibial stem extension. A successful outcome was achieved with union of the fracture, a mobile-painless knee, and limb realignment.