Management and Outcome of Periprosthetic Fractures After Total Knee Arthroplasty

Abstract

Compared with current data in literature, we had a satisfactory outcome in following individualized treatment of periprosthetic fractures after knee joint replacement. Referring to the wide field of treatment options and high rates of complications, periprosthetic femoral fractures around the knee commonly constitute a challenging problem for the treating surgeons and require an adequate analysis of fracture etiology and a corresponding transfer into an individual treatment concept.

Retrograde Marknagelung bei periprothetischen Frakturen des distalen Femurs

“…Für die Behandlung periprothetischer Frakturen des distalen Femurs sind verschiedenste Verfahren beschrieben worden [2,3,4,5,11,16,20,22,25,26]. Die Behandlung undislozierter Frakturen mittels Gipsruhigstellung, Orthese oder Fixateur externe ist in Ausnahmefällen mög-lich, jedoch erlaubt die operative Stabilisation eine unmittelbare Bewegungstherapie und wird daher meist bevorzugt [3,16].…”

Periprosthetic fractures: epidemiology and current treatment

“…Other studies showed that almost 50% of patient with humeral PF had a diagnosis of RA (3). Platzer et al (13) reported the presence of severe osteoporosis or RA in 73% of patients treated for distal femoral PF. The evalutation of implants fixation and the prevention of loosening are essential in order to reduce the risk of PFs.…”

Periprosthetic Total Knee Arthroplasty Fractures: Revision Arthroplasty Technique

“…3 Indications Surgical treatment goals for periprosthetic fractures around TKA implants include restoration of stability and facilitation of joint motion. Although most fractures can be treated with internal fixation, 4 there are a notable minority of patients for whom additional considerations may limit the effectiveness of internal fixation and increase the benefits of revision total knee arthroplasty as a primary treatment approach.…”

“…Large osteolytic defects may directly undermine fracture stability or may contribute to implant failure after fracture repair (►Figs. [3][4][5][6]. The adverse bone remodeling in response to aging, metabolic diseases including osteoporosis, or a history of limited weight bearing may also adversely impact the ability to provide adequate stability with an internal fixation construct.…”