Supracondylar fracture of the femur associated with polyethylene wear after total knee arthroplasty. A case report.

Rand, J A

doi:10.2106/00004623-199409000-00015

Cited by 39 publications

(10 citation statements)

References 7 publications

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“…The other 2 patients, with no notching, developed supracondylar fractures of the femur 6 months and 9 months after their TKR and they had rheumatoid arthritis, which is associated with poor bone quality. The literature has shown that various factors contribute to the pathogenesis of supracondylar fracture of the femur after TKR such as the relative difference in elastic modulus between the femoral cortex and the metal prosthesis, stress shielding caused by the anterior femoral flange at bone-metal junction, postoperative hypovascularity leading to inadequate osseous remodeling, osteolysis caused by polyethylene wear debris (Rand 1994), and bone cement or metal causing endosteal ischemia (Short et al 1981, Ritter et al 1988). A combination of the axial and torsional loads plays an important role in the mechanism of these fractures (Insall 1984, Culp et al 1987).…”

Section: Discussionmentioning

confidence: 99%

Risk of periprosthetic fracture after anterior femoral notching

Gujarathi

Putti²,

Abboud

et al. 2009

Acta Orthopaedica

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Background Notching of the anterior femoral cortex in distal femoral fractures following TKR has been observed clinically and studied biomechanically. It has been hypothesized that femoral notching weakens the cortex of the femur, which can predispose to femoral fractures in the early postoperative period. We examined the relationship between notching of the anterior femoral cortex during total knee replacement (TKR) and supracondylar fracture.Patients and methods Postoperative lateral radiographs of 200 TKRs were reviewed at an average of 9 (6–15) years postoperatively. 72 knees (41%) showed notching of the anterior femoral cortex. Notches were classified into 4 grades using the Tayside classification as follows. Grade I: violation of the outer table of the anterior femoral cortex; grade II: violation of the outer and the inner table of the anterior femoral cortex; grade III: violation up to 25% of the medullary canal (from the inner table to the center of the medullary canal); grade IV: violation up to 50% of the medullary canal (from the inner table to the center of the medullary canal) and unclassifiable.Results The interobserver variability of the classification system using Cohen's Kappa score was found to be substantially reliable. 3 of the 200 TKRs sustained later supracondylar fractures. One of these patients had grade II femoral notching and the other 2 showed no notching. The patient with femoral notching sustained a supracondylar fracture of the femur following a simple fall at home 9 years after TKR.Interpretation There is no relationship between minimal anterior femoral notching and supracondylar fracture of the femur in TKR.

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Section: Discussionmentioning

confidence: 99%

Risk of periprosthetic fracture after anterior femoral notching

Gujarathi

Putti²,

Abboud

et al. 2009

Acta Orthopaedica

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“…A number of factors have been implicated in the pathogenesis of the fracture. These vary from stress shielding to avascularity of the adjacent bone and osteolysis of the bone, related to polyethylene wear debris [5][6][7]. It is also worthy of note that pathological fracture can occur following the closed manipulation of the stiff knee joint post-arthroplasty [8,9].…”

Section: Aetiologymentioning

confidence: 99%

The use of megaprosthesis in the treatment of periprosthetic knee fractures

Cannon

2015

International Orthopaedics (SICOT)

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“…Studies have been published considering its relevance, 13 and one case report has been published proposing poor component positioning as a risk factor for periprosthetic fracture. 15 It is probable that inaccurate component positioning is more likely to cause intra-operative periprosthetic fracture as a result of the bone preparation that has preceded it. These complications are under-reported in the literature.…”

Section: Epidemiology and Aetiologymentioning

confidence: 99%

Periprosthetic fractures around total knee arthroplasty

Davis

Higgins

2014

Trauma

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Periprosthetic fractures around total knee replacements were first reported more than 30 years ago. They are becoming more common. Various associated risk factors have been described. Treatment options for femoral fractures around total knee replacements include non-operative management, locked plates, retrograde intramedullary nails and revision arthroplasty. Periprosthetic fractures of the tibia and patella are also described, but are less common. This review article provides an overview of the epidemiology and frequency of periprosthetic fractures around total knee replacement, their initial assessment and the current treatment options available.

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Supracondylar fracture of the femur associated with polyethylene wear after total knee arthroplasty. A case report.

Cited by 39 publications

References 7 publications

Risk of periprosthetic fracture after anterior femoral notching

Risk of periprosthetic fracture after anterior femoral notching

The use of megaprosthesis in the treatment of periprosthetic knee fractures

Periprosthetic fractures around total knee arthroplasty

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