Intercondylar distal femoral fracture: An unreported complication of posterior stabilized total knee arthroplasty

Lombardi, Adolph V.; Waterman, Robert A.; Eberle, Robert

doi:10.1016/0883-5403(94)90173-2

Cited by 31 publications

(77 citation statements)

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“…Component design may additionally influence intraoperative fracture, as suggested by Lombardi et al [12]. In their study, the authors suggest the box cut associated with the posterior-stabilized Insall-Burstein Constrained Condylar Knee II design (Zimmer, Inc, Warsaw, IN) may predispose to condylar fracture.…”

Section: Discussionmentioning

confidence: 80%

“…Stuart and Hanssen [16] reported four intraoperative fractures of the lateral tibial cortex during primary TKAs associated with placement of the final components. Lombardi et al [12] reviewed the complications of intraoperative distal femur intercondylar fractures, reporting 40 fractures in 898 primary posteriorstabilized TKAs (4.4%). The authors attribute this high fracture rate to intercondylar box cuts, which were slightly narrow or placed excessively medial or lateral, thereby weakening the respective condyle.…”

Section: Discussionmentioning

confidence: 99%

“…The most common time for fracture was during exposure and bone preparation (39%) and while testing the trial components (33%). It has been postulated osteoporosis, female gender, chronic steroid use, advanced age, rheumatoid arthritis, and neurologic disorders predispose to postoperative periprosthetic fracture and may be factors important in intraoperative fractures [1,4,7,12,16].…”

Section: Discussionmentioning

confidence: 99%

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Intraoperative Fracture During Primary Total Knee Arthroplasty

Alden

Duncan

Trousdale

et al. 2010

Clinical Orthopaedics &Amp; Related Research

180

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While the occurrence of periprosthetic fractures around total knee arthroplasties (TKAs) is well know, little is known about intraoperative fractures that occur during TKA. We describe the incidence, location, and outcomes of iatrogenic intraoperative fracture during primary TKA. We reviewed 17,389 primary TKAs performed between 1985 and 2005 and identified 66 patients with 67 intraoperative fractures including 49 femur fractures, 18 tibia fractures, and no patella fractures. There were 12 men and 54 women with a mean age of 65.2 ± 16 years. Of the 49 femur fractures, locations included medial condyle (20), lateral condyle (11), supracondylar femur (eight), medial epicondyle (seven), lateral epicondyle (two), and posterior cortex (one). Tibia fractures (18) included lateral plateau (six), anterior cortex (four), medial plateau (three), lateral cortex (three), medial cortex (one), and posterior cortex (one).Twenty-six fractures occurred during exposure and preparation, 22 while trialing, 13 during cementation, and three while inserting the polyethylene spacer. The minimum followup was 0.15 years (mean, 5

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intraoperative Fracture During Primary Total Knee Arthroplasty

Alden

Duncan

Trousdale

et al. 2010

Clinical Orthopaedics &Amp; Related Research

180

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“…[1][2][3] The reported incidence may be under-estimated, as a clinically insignificant fracture may be missed. Risk factors for patellar fracture during revision knee surgery include weakened bone secondary to concurrent osteolysis, avascular necrosis, and comorbidities (osteoporosis and rheumatoid arthritis).…”

Section: Discussionmentioning

confidence: 99%

“…1 Preserving bone stock is essential in posterior-stabilised TKA. 2 This study reviewed 6 cases of periprosthetic distal femoral fracture during TKA.…”

Section: Introductionmentioning

confidence: 99%

Distal Femoral Fracture during Primary Total Knee Arthroplasty

Delasotta

Orozco

Miller

et al. 2015

J Orthop Surg (Hong Kong)

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Purpose. To review 6 cases of periprosthetic distal femoral fracture during total knee arthroplasty (TKA). Methods. Of 778 women and 691 men who underwent primary TKAs using posterior-stabilised (n=1240), cruciate-retaining (n=165), or semiconstrained (n=64) implant, 5 women and one man with a mean age of 73.3 years and a mean body mass index of 31.6 kg/m 2 sustained an intra-operative periprosthetic distal femoral fracture and were followed up for a mean of 12.8 (range, 2-39) months. Results. Respectively in patients with a posteriorstabilised, cruciate-retaining, or semi-constrained implant, the intra-operative fracture rates were 0.32%, 0%, and 3.13%. For women, the respective rates were 0.46%, 0%, and 5.10%. Intra-operative fracture was 9.69 times (p=0.03) more likely to occur in patients with a semi-constrained implant than those with a posterior-stabilised implant, and was 4.44 times (p=0.22) more likely to occur in women than in men. Half of the fractures occurred during the trial phase Distal femoral fracture during primary total knee arthroplasty

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