Non-union Hoffa's Fracture in an Adult Male Managed with Total Knee Arthroplasty: A Rare Case Report.

Abstract

Introduction: Coronal plane fractures of the femoral condyle, known as Hoffa's fractures, are uncommon intra-articular injuries. Non-union of such fractures is rarely reported, particularly in younger patients, and presents a complex clinical scenario.

Case report: A case of a 38-year-old male who reported chronic right knee pain, swelling, and difficulty in ambulation due to a non-union Hoffa's fracture. Radiological findings indicated joint surface degeneration and instability. Given the chronicity and extent of articular damage, the patient underwent total knee arthroplasty (TKA) along with open reduction and internal fixation (ORIF) of the medial femoral condyle under spinal anesthesia. A posterior-stabilized knee system (Smith and Nephew, femur-5, tibia-5, polyethylene insert 13 mm) was implanted using Palacos bone cement. The patient recovered well and regained mobility with significant pain relief.

Conclusion: In rare cases of non-union Hoffa's fractures with joint degeneration, combined TKA and ORIF can provide functional improvement and pain relief, even in younger adults, when performed with appropriate surgical planning.