Extension Malunion of the Femoral Component After Retrograde Nailing

Pelfort, Xavier; Torres-Claramunt, Raúl; Hinarejos, Pedro; Leal, Joan; Gil-Gónzalez, Sergi; Puig, Lluís

doi:10.1097/bot.0b013e3182629641

Cited by 41 publications

(23 citation statements)

References 20 publications

(9 reference statements)

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“…Hyperextension of the femoral component may be noted in the sagittal plane because reaming and insertion are performed with the knee in flexion position, which is more notable when the insertion site is extremely posterior to the intercondylar notch. According to Pelfort et al25), hyperextension of the femoral component did not significantly affect stability of the prosthesis, bone union and knee joint function. Besides, valgus malalignment of the distal fragment in the coronal plane is often encountered after fracture treatment.…”

Section: Supracondylar Fractures Of the Femurmentioning

confidence: 90%

“…To avoid this, it is recommended to use a blocking screw as a guide for proper insertion of the intramedullary nail26). Contraindications to intramedullary nailing include patellar baja, joint ankylosis precluding intramedullary nail insertion, <11 mm intercondylar distance or narrow medullary cavity, preexisting intramedullary stem in the proximal femur from previous total hip arthroplasty, severe comminution or extremely distal fracture precluding stable internal fixation and unstable TKA prosthesis24,25,26). Some PCL-substituting implants are closed box designs in which the metal intercondylar box completely covers the intercondylar notch, allowing insertion of an interamedullary nail after drilling with a diamond-tip metal-cutting burr27).…”

Section: Supracondylar Fractures Of the Femurmentioning

confidence: 99%

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Periprosthetic Fractures Following Total Knee Arthroplasty

Yoo

Kim

2015

Knee Surg Relat Res

116

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Periprosthetic fractures after total knee arthroplasty may occur in any part of the femur, tibia and patella, and the most common pattern involves the supracondylar area of the distal femur. Supracondylar periprosthetic fractures frequently occur above a well-fixed prosthesis, and risk factors include anterior femoral cortical notching and use of the rotational constrained implant. Periprosthetic tibial fractures are frequently associated with loose components and malalignment or malposition of implants. Fractures of the patella are much less common and associated with rheumatoid arthritis, use of steroid, osteonecrosis and malalignment of implants. Most patients with periprosthetic fractures around the knee are the elderly with poor bone quality. There are many difficulties and increased risk of nonunion after treatment because reduction and internal fixation is interfered with by preexisting prosthesis and bone cement. Additionally, previous soft tissue injury is another disadvantageous condition for bone healing. Many authors reported good clinical outcomes after non-operative treatment of undisplaced or minimally displaced periprosthetic fractures; however, open reduction or revision arthroplasty was required in displaced fractures or fractures with unstable prosthesis. Periprosthetic fractures around the knee should be prevented by appropriate technique during total knee arthroplasty. Nevertheless, if a periprosthetic fracture occurs, an appropriate treatment method should be selected considering the stability of the prosthesis, displacement of fracture and bone quality.

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Section: Supracondylar Fractures Of the Femurmentioning

confidence: 90%

Section: Supracondylar Fractures Of the Femurmentioning

confidence: 99%

Periprosthetic Fractures Following Total Knee Arthroplasty

Yoo

Kim

2015

Knee Surg Relat Res

116

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“…We also have learned that it is expected some degree of hyperextension when treating theses fractures with a retrograde nail, but as we have learned from Pelfort et al [8] this issue dońt have a clinical repercussion.…”

Section: Discussionmentioning

confidence: 86%

“…Pelfort et al [8] demonstrate that patients treated with a retrograde nail, who united in extension, had a good clinical outcome, and none of the patients had signs of nonunion of implant loosening.…”

Section: Discussionmentioning

confidence: 97%

The number of locking screws predicts the risk of nonunion and reintervention in periprosthetic total knee arthroplasty fractures treated with a nail

Toro-Ibarguen

Moreno-Beamud

Porras-Moreno

et al. 2014

Eur J Orthop Surg Traumatol

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Periprosthetic knee fractures following total knee arthroplasty are increasing proportionally to the number of primary procedures done. We performed a retrospective review of Rorabeck type II fractures treated with a retrograde nail, trying to find the relationship between failure and the number of distal locking screws used. Twenty-six patients were included. The number of distal interlocking screws (patients with one or two distal interlocking screws and patients with three screws) correlated with nonunion (p < 0.1), did not correlate with the malunion rate (p > 0.1) and correlated with the reintervention rate (p < 0.1).

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“…[37] Bununla birlikte, Pelfort ve ark. [38] , bir miktar hiperekstansiyon bozukluğunun diz protezi stabilitesini veya fonksiyonel sonucu değiştirmediğini göstermiştir. Tersine, valgus deformitesi zor tolere edilir.…”

Section: Tedavi̇ Seçenekleri̇ Ve Sonuçlari Femurunclassified

Total diz artroplastisi ile ilişkili periprostetik kırıklar

Özkayın¹,

Yener²

2019

TOTBID

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Bu kırıkların oluşma mekanizmasında rol oynayan faktörler arasında; femoral komponentin anterior kenarının stres kalkanı oluşturması, operasyon sonrası kan akımı azalmasıyla kemik remodelizasyonunun bozulması, içinde implant bulunan kemik kısım ile bulunmayan kemik kısım arasındaki elastik modulus farkı gösterilebilir. [5] Bu kırıkların insidansının gittikçe yükselmesinin nedeni, yaşlı popülasyonun ve buna bağlı TDA yapılma sıklığının artması olabilir. D iz çevresi periprostetik kırıkları, total diz artroplastisi (TDA) sırasında veya sonrasında ortaya çıkan, diz eklemine 15 cm mesafe içinde veya varsa protezin intramedüller stemine 5 cm mesafe içinde oluşan kırıklardır. [1] TDA sonrası bu kırıkların oluşma insidansı femur için %0,3-2,5 olarak belirtilirken [2] , tibia için bu oran %0,4-1,7 [3] , patella için daha da az olarak bildirilmektedir. Bu kırıkların çok büyük bir çoğunluğu basit düşme gibi düşük enerjili travmalar Total diz artroplastisi ile ilişkili periprostetik kırıklar

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Extension Malunion of the Femoral Component After Retrograde Nailing

Cited by 41 publications

References 20 publications

Periprosthetic Fractures Following Total Knee Arthroplasty

Periprosthetic Fractures Following Total Knee Arthroplasty

The number of locking screws predicts the risk of nonunion and reintervention in periprosthetic total knee arthroplasty fractures treated with a nail

Total diz artroplastisi ile ilişkili periprostetik kırıklar

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