Fratura bilateral do fêmur distal após artroplastia total do joelho

Loures, Fabrício Bolpato; Motta, Jorge Rafael Wenck; Albuquerque, Rodrigo Pires e; Barretto, João Maurício; Cavanellas, Naason Trindade

doi:10.1016/j.rbo.2015.10.011

Cited by 2 publications

(7 citation statements)

References 9 publications

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“…Risk factors for these PPFs include patient specific factors such as elderly, female sex, osteoporosis, a history of revision arthroplasty, chronic steroid therapy, rheumatoid arthritis, and neurologic disorders [ 1 , 3 , 4 ]. Radiographic osteolysis, infection, and navigation-assisted arthroplasty are also considered as pre-disposer to fracture [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Radiographic osteolysis, infection, and navigation-assisted arthroplasty are also considered as pre-disposer to fracture [ 4 ]. Technique-related factors like anterior femoral notching are a risk factor for supracondylar fracture femur [ 3 , 4 ]. Although notching is implicated, larger series do not show any clear association [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…If the implant is stable, immobilization is unlikely to maintain reduction of a fracture, surgery is appropriate. The purpose of the surgical procedure in this type of fractures is to preserve limb length, restore rotational alignment, and allow early motion [ 1 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Incidence of patellar fractures has been reported as 0.2–21% in the patella resurfaced knee and 0.05% in the non-resurfaced knee [ 2 , 4 , 7 ]. Low-energy trauma is most common mechanism of injury though in 10% high-energy trauma may be the causative factor [ 3 , 4 ]. The floating knee injury (FKI) around total knee arthroplasty (TKA) is a rare and challenging scenario.…”

Section: Introductionmentioning

confidence: 99%

“…It is usually associated with injuries to head, chest, abdomen, and limbs with overall death rate on admission up to 10% [ 5 ]. Despite all efforts to understand and treat these patients, high rate of complications (50%) and mortality are still reported [ 3 ]. Very few case reports are available in literature to delineate treatment algorithm or management strategy for such complex trauma [ 6 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Bilateral Periprosthetic Knee Fracture with the Right Floating Total Knee and Left Periprosthetic Patella Fracture Management Strategy: A Case Report

Tomar

Govil

Dhawan

2021

JOCR

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Introduction: Periprosthetic fractures (PPFs) in total knee replacement are an uncommon condition. The floating knee injury around total knee arthroplasty (TKA) is even rare and poses challenges in management. Incidence is increasing due to growing primary joint arthroplasties and revision procedures. We report a case of bilateral PPF with a floating total knee. Case Report: A 74-year-old female involved in a violent car accident sustained bilateral knee injuries, facial, and hand injury. In the emergency room, the initial resuscitation and trauma protocol stabilization were done and she was provisionally immobilized for her limb injuries. She presented with the right-sided floating total knee involving periprosthetic periarticular comminuted distal femur fracture and midshaft comminuted fracture tibia fibula. The patient also had left knee lower pole periprosthetic patellar fracture. The patient had a history of bilateral TKA around 2 years back. She underwent surgical management of the right floating total knee by stabilization of distal femur fracture and tibial shaft fracture fixation with locking plates. She underwent primary autologous bone grafting for both fracture sites. The left knee patellar fracture was managed conservatively in a brace. At 8 months follow-up, the patient was pain free and had consolidation of fractures. The patient walked without any walking aids. At 18 months, she had regained her pre-injury functional status. Conclusion: Each fracture in a floating total knee injury is unique and treatment should be decided based on individual analysis and the extent of soft-tissue injuries. An uncommon occurrence highlights the complex injury patterns involving PPF requiring individualized case specific management strategy. Keywords: Floating total knee, Periprosthetic knee fracture, floating knee.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bilateral Periprosthetic Knee Fracture with the Right Floating Total Knee and Left Periprosthetic Patella Fracture Management Strategy: A Case Report

Tomar

Govil

Dhawan

2021

JOCR

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Impact of time to surgery from injury on postoperative infection and deep vein thrombosis in periprosthetic knee fractures

Lee

Shrestha

Staggers

et al. 2018

Chinese Journal of Traumatology

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PurposePeriprosthetic fracture (PPF) is a serious complication that occurs in 0.3%–2.5% of all total knee arthroplasties used to treat end-stage arthritis. To our knowledge, there are no studies in the literature that evaluate the association between time to surgery after PPF and early postoperative infections or deep vein thrombosis (DVT). This study tests our hypothesis that delayed time to surgery increases rates of postoperative infection and DVT after PPF surgery.MethodsOur study cohort included patients undergoing PPF surgery in the American College of Surgeons National Surgical Quality Improvement Program database (2006–2015). The patients were dichotomized based on time to surgery: group 1 with time ≤2 days and group 2 with time >2 days. A 2-by-2 contingency table and Fisher's exact test were used to evaluate the association between complications and time to surgery groups, and multivariate logistic regression was used to adjust for demographics and known risk factors.ResultsA total of 263 patients (80% females) with a mean age of 73.9 ± 12.0 years were identified receiving PPF surgery, among which 216 patients were in group 1 and 47 patients in group 2. Complications in group 1 included 3 (1.4%) superficial infections (SI), 1 (0.5%) organ space infection (OSI), 1 (0.5%) wound dehiscence (WD), and 4 (1.9%) deep vein thrombosis (DVT); while complications in group 2 included 1 (2.1%) SI, 1 (2.1%) OSI, 1 (2.1%) DVT, and no WD. No significant difference was detected in postoperative complications between the two groups. However, patients in group 2 were more likely (p = 0.0013) to receive blood transfusions (57.5%) than those in group 1 (32.4%).ConclusionOur study indicates patients with delayed time to surgery have higher chance to receive blood transfusions, but no significant difference in postoperative complications (SI, OSI, WD, or DVT) between the two groups.

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Fratura bilateral do fêmur distal após artroplastia total do joelho

Cited by 2 publications

References 9 publications

Bilateral Periprosthetic Knee Fracture with the Right Floating Total Knee and Left Periprosthetic Patella Fracture Management Strategy: A Case Report

Bilateral Periprosthetic Knee Fracture with the Right Floating Total Knee and Left Periprosthetic Patella Fracture Management Strategy: A Case Report

Impact of time to surgery from injury on postoperative infection and deep vein thrombosis in periprosthetic knee fractures

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