Outcome of Osteosynthesis for Periprosthetic Fractures After Total Knee Arthroplasty: a Retrospective Study

Overview

Journal Eur J Orthop Surg Traumatol

Specialty Orthopedics

Date 2018 Jan 5

PMID 29299767

Citations 5

Authors

Hasmukh Nagwadia

Prateek Joshi

Affiliations

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Abstract

Introduction: Incidence of periprosthetic fractures around knee is going to rise in near future due to dramatic increase in total knee arthroplasty (TKA). Our study is a retrospective case series describing the outcome of osteosynthesis for periprosthetic fractures after TKA.

Materials And Methods: We analyzed the outcome of osteosynthesis for periprosthetic fractures with stable implants in 43 patients having 45 fractures operated between 2010 and 2015.

Results: Out of 43 patients, the majority were female (M-15, F-28) with mean age of 65.95 years, majority had left knee involved (L-24, R-19), with fractures involving femur, tibia and patella, respectively, in 29, 11 and 5 patients. Fracture pattern was Rorabeck type 2 in 29, Felix type 2 in 6, type 3 in 5, Goldberg type 2 in 3, type 3a in 2, Unified classification system type A in 2, B1 in 35, C in 4, E in 2 cases. Anterior femoral cortex notching was found in 13 patients with femoral fractures. According to Tayside classification, 12 patients had type 1 and one had type 2 notching. Different implants were used according to the need of the fractures. After TKA, the mean Hospital for Special Surgery score was 84.2, which reduced to mean 76 at 9 months following osteosynthesis. Three patients had nonunion, one had delayed union and one had implant failure.

Conclusions: Osteosynthesis for periprosthetic fractures around knee with locked compression plate gives promising results. Fractures involving patella are associated with inferior functional outcome. Understanding the fracture pattern and bone stock available for fixation with correct choice of implant and correct surgical technique gives promising outcome in periprosthetic fractures around knee.

Citing Articles

Periprosthetic distal femoral fractures after total knee replacement treated by ORIF. Mid to long-term follow-up study in 12 patients.

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PMID: 37786428 PMC: 10542000. DOI: 10.52965/001c.87871.

Tibial periprosthetic fractures in Total Knee Arthroplasty - A scoping review.

Shukla T, Vaish A, Vaishya R, Patralekh M J Clin Orthop Trauma. 2022; 29:101892.

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The race for the classification of proximal periprosthetic femoral fractures : Vancouver vs Unified Classification System (UCS) - a systematic review.

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Periprosthetic tibial fracture after total knee arthroplasty with popliteal artery injury-A case report.

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