Treatment of juxtaarticular nonunion fractures at the knee with long-stem total knee arthroplasty.

A retrospective study of ten patients with juxtaarticular nonunions at the knee treated with long stem total knee arthroplasty was performed. The average age of the patients was 76 years old, with an average follow-up of 36 months. The nonunions were present for an average of 36 months. There were six patients in the series with prior total knee arthroplasty. Clinical union was achieved in all ten patients. All patients improved their ambulatory status. Range of motion improved from an average preoperative range of 40 degrees to an average postoperative range of 85 degrees. Complications occurred in three of ten patients, with one being a postoperative infection. Surgical techniques are described to aid in treatment of difficult juxtaarticular nonunion fragments.