Proximal Tibial Stress Fractures Associated With Primary Degenerative Knee Osteoarthritis

Tibial stress fractures are not rare—they have been extensively studied in young athletes and soldiers and in elderly people with rheumatoid arthritis, osteoporosis, Paget’s disease, pyrophosphate arthropathy, and hyperparathyroidism—but they seldom occur in patients with severe primary degenerative knee osteoarthritis. The etiology, diagnosis, and optimal treatment of these fractures remain a challenge. In this article, we review the English-language literature on the symptoms, diagnosis, treatment options, and final outcomes of these fractures, and we report 2 new cases of proximal tibial stress fractures in elderly women with severe primary degenerative knee osteoarthritis.