Intraoperative Fracture During Primary Total Knee Arthroplasty

Abstract

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

Intra-Operative Fracture in Posterior-Stabilised Total Knee Arthroplasty

“…1 One limitation of this study was the absence of controls for comparison. Nonetheless, comparative study is difficult because of the low prevalence of intra-operative fracture.…”

“…[1][2][3][4][5] This study reviewed records of 17 patients who sustained a tibial (n=12) or femoral (n=5) intra-operative fracture during primary cemented TKA.…”

Periprosthetic fractures: epidemiology and current treatment

“…In TKA, the implant design influences the type of resection from the intercondylar notch. So, the relative risk for distal femoral fracture is 4.74 when comparing a posterior-stabilized implant with a cruciate-retaining implant (21). In TSA, no definitive conclusions could be reached about the impact of implant design, technique for preparation of the humerus and glenoid, and cemented vs cementless implantation on PF incidence.…”

Influence of the distal femoral resection angle on the principal stresses in ceramic total knee components

“…Although femoral fractures during impaction of total knee components have been reported previously by Hernigou et al and Alden et al [18,19], the analysed knee did not show critical stresses under the given boundary conditions. In that case, a fully dynamic model might provide advanced results but was not focus of this study.…”