Femoral Revision Arthroplasty for Su Type 3 Supracondylar Periprosthetic Knee Fractures

Deshmukh, Ajit; Thakur, Raman; Rasquinha, Vijay J.; Rodríguez, José A.

doi:10.1055/s-0034-1390029

Cited by 6 publications

(11 citation statements)

References 21 publications

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“…The distal femoral replacement group did not have an increased complication rate; on the contrary, the recovery of patients was quicker with a shortened surgical time and decreased blood loss. Thakur et al [60] reported the results in 16 knees with acute Su type III, supracondylar periprosthetic fractures. All patients mentioned in their article returned to pre-fracture activity level.…”

Section: Revision Total Knee Replacementmentioning

confidence: 99%

Periprosthetic fractures of the knee: a comprehensive review

Benkovich

Klassov

Mazilis

et al. 2019

Eur J Orthop Surg Traumatol

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Demographic changes have resulted in an increase in the number of older patients diagnosed with degenerative joint disease. Developments in the field of joint arthroplasty allow a broader population to improve their lifestyles. An increased demand for knee arthroplasty has led to a rise in operations performed worldwide. Although there has been a constant propagation of technology and an increase in medical staffing at a professional level, many patients still encounter complications. Though rare, these factors may lead to life-threatening scenarios and a devastating effect on the success of the operation. One such rare complication includes periprosthetic fractures around the knee, a complex injury which requires a cautious and experienced approach. In this review, we analyze the prevalence, risk factors and classification, investigation and treatment options for periprosthetic fractures with total knee arthroplasty.

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Section: Revision Total Knee Replacementmentioning

confidence: 99%

Periprosthetic fractures of the knee: a comprehensive review

Benkovich

Klassov

Mazilis

et al. 2019

Eur J Orthop Surg Traumatol

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“… 26 , 27 This may sometimes be a treatment option in cases where stability has been preserved between the bone and implant, and in Type 3 cases where bone stock is not of a sufficient amount and quality in the distal. 28 …”

Section: Discussionmentioning

confidence: 99%

An alternative treatment for osteoporotic Su Type III periprosthetic supracondylar femur fractures: Double locking plate fixation

Çıçek¹,

Tuhanioğlu²,

Oğur³

et al. 2018

Acta Orthopaedica et Traumatologica Turcica

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IntroductionPatients with Su Type III fractures based on total knee arthroplasty (TKA) constitute a patient group with problematic treatment and management. Although it has difficulties, open reduction and internal fixation is one of the treatment options.MethodA retrospective evaluation was made of 22 patients surgically treated in our clinic with double locking, low contact titanium plate and screw for a Su Type III periprosthetic fracture based on TKA. The patients were evaluated with bone mineral densitometry, postoperative Knee Society Score (KSS), WOMAC and radiological evaluations.ResultsThe mean follow-up period of the patients was 68.6 ± 15.5 months, with pain-free weight-bearing determined at 4.9 ± 1.1 months and mean radiological union at 18.5 ± 4.3 weeks. Revision was required because of non-union in 2 (9.09%) cases. The postoperative KSS value was 81.8 ± 7.8, the WOMAC value was 78.1 ± 5.3 and the T-score was −3.3 ± 0.3. At the final follow-up examination, a correction loss (4.9° ± 1.5°) was determined in the mean knee valgus angle according to the mechanical axis, which was statistically significant but remained within the physiological limits (p = 0.21).ConclusionIn addition to providing the advantages of rigid fixation together with early and effective rehabilitation, satisfactory clinical and radiological results were obtained with the application of double locking plate and screw in the treatment of periprosthetic femoral fractures based on TKA, with osteoporosis.Level of evidenceLevel IV, Therapeutic study.

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“…10,21,32,36,37,39,41,46,47 The proportion of patients returning to preoperative mobility ranged from 37.5% to 95.2% in the DFLP group 10,33,38,39,42 and 27.3%-100.0% in the DFR group. 10,37,[39][40][41]47 Functional Outcomes Functional outcomes are reported in Table 3. The KSS ranged from 70.4 to 86.0 for DFLP knees [34][35][36]49,51 and from 67.2 to 86.0 for DFR knees.…”

Section: Clinical Outcomesmentioning

confidence: 98%

“…10,18,19,21, Seventeen studies reported on ORIF with DFLPs in 440 knees in 440 patients (12 retrospective studies 10,18,33,34,36,39,42,45,[49][50][51][52] and 5 case series 35,38,43,44,48 ). Eleven studies reported on DFR in 209 knees in 205 patients (9 retrospective studies 10,19,21,32,36,37,39,40,47 and 2 case series 41,46 ) (see Table, Supplemental Digital Content 2, http://links.lww.com/JOT/B368 for summarized study characteristics). The average age of DFLP knees ranged from 65.9 to 88.3 years, and the average age of DFR knees ranged from 71.0 to 84.8 years.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

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Very Distal Femoral Periprosthetic Fractures: Replacement Versus Fixation: A Systematic Review

Rubinger

Khalik

Gazendam

et al. 2021

Journal of Orthopaedic Trauma

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Objectives: To synthesize all-cause reoperations and complications data as well as secondary clinical and functional outcomes, after the management of very distal femur periprosthetic fractures (vDFPFs) in a geriatric patient population with either a distal femoral locking plate (DFLP) or distal femoral replacement (DFR).Data Sources: MEDLINE, Embase, and Web of Science were searched for English language articles from inception to March 16, 2020, in accordance to the PRISMA guidelines. Study Selection: Studies reporting the management of vDFPFs in adults older than 65 years with either a DFLP or DFR were included. To ensure this review solely focused on very distal femoral periprosthetic fractures, only fractures of the following classifications were included: (1) Lewis and Rorabeck type II or III, (2) Su and Associates' Classification of Supracondylar Fractures of the Distal Femur type III, (3) Backstein et al type F2, and/or (4) Kim et al type II or III.Data Extraction: Three reviewers independently extracted data from the included studies. Study validity was assessed using the methodological index for nonrandomized studies (MINORS), a quality assessment tool for nonrandomized controlled studies in surgery.Data Synthesis: Twenty-five studies with 649 vDFPFs were included for analysis. There were 440 knees in the DFLP group (mean age range: 65.9-88.3 years) and 209 knees in the DFR group (mean age range: 71.0-84.8 years). Because of the literature's heterogeneity, the data were qualitatively synthesized.Conclusions: vDFPFs in the elderly treated with DFR underwent fewer reoperations relative to DFLP (0%-45% vs. 0%-77%, respectively). Time to weight-bearing was observably shorter in DFR studies relative to DFLP studies. Functional outcomes and postoperative range of motion indicated a trend for DFLP knees to outperform DFR knees. Future research should include prospective studies and cost-effectiveness evaluations to better understand the utility of DFR for these fractures.

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Femoral Revision Arthroplasty for Su Type 3 Supracondylar Periprosthetic Knee Fractures

Cited by 6 publications

References 21 publications

Periprosthetic fractures of the knee: a comprehensive review

Periprosthetic fractures of the knee: a comprehensive review

An alternative treatment for osteoporotic Su Type III periprosthetic supracondylar femur fractures: Double locking plate fixation

Very Distal Femoral Periprosthetic Fractures: Replacement Versus Fixation: A Systematic Review

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