Fixation of supracondylar femoral fractures following total knee arthroplasty: is there any difference comparing angular stable plate fixation versus rigid interlocking nail fixation?

Aldrian, Silke; Schuster, Rupert; Haas, N; Erhart, Jochen; Strickner, M.; Blutsch, Beate; Wernhart, Simon; Leitgeb, Johannes; Platzer, Patrick

doi:10.1007/s00402-013-1730-9

Cited by 34 publications

(17 citation statements)

References 15 publications

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“…In all of the failing specimens fixed with nail osteosynthesis, the results of the present study revealed that diaphyseal transverse fracture through the proximal screw was the reason for failure. These results contradict to our own clinical experience and the results of a multitude of clinical studies that have primarily reported failure of the distal screws [1,26,36], even enabling the opportunity for nail migration into the knee [13,30]. This elevated rate of diaphyseal transverse fracture through the proximal screw in nail osteosynthesis might be explained by the fact that only an axial load was applied.…”

Section: Load In Newton (N) Deformation In Milimeter (Mm)contrasting

confidence: 83%

Distal femoral fractures in the elderly: biomechanical analysis of a polyaxial angle-stable locking plate versus a retrograde intramedullary nail in a human cadaveric bone model

Bliemel

Buecking

Mueller

et al. 2014

Arch Orthop Trauma Surg

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Based on our results, no statements regarding the superiority of either of the devices can be made. Even though the load to failure values for both osteosyntheses were much higher than the loads experienced during normal walking; however, because only axial loading was applied, it remains unclear whether both osteosyntheses meet the estimated requirements for postoperative full weight-bearing for an average heavy patient with a distal femoral fracture.

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Section: Load In Newton (N) Deformation In Milimeter (Mm)contrasting

confidence: 83%

Distal femoral fractures in the elderly: biomechanical analysis of a polyaxial angle-stable locking plate versus a retrograde intramedullary nail in a human cadaveric bone model

Bliemel

Buecking

Mueller

et al. 2014

Arch Orthop Trauma Surg

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“…Revision rate was reported in 3 studies (n = 98) with a moderate level of heterogeneity (I 2 = 52%) [9,11,12]. The difference between the LCP and RIMN groups in terms of revision rate was not statistically significant (Fig.…”

Section: Outcome 5: Revision Ratementioning

confidence: 95%

“…More recently, the use of both locking compression plates (LCP) and retrograde intramedullary nailing (RIMN) has proved successful methods of fixation [7,11,12]. However, the ideal treatment modality remains controversial where a consensus is not clear in the literature [7,[12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Locked compression plating versus retrograde intramedullary nailing in the treatment of periprosthetic supracondylar knee fractures: a systematic review and meta-analysis

et al. 2021

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Background Periprosthetic fractures of the distal femur above a total knee arthroplasty (TKA) have traditionally been managed by locking compression plating (LCP). This technique is technically demanding and is associated with high rates of non-union and revision. More recently, retrograde intramedullary nailing (RIMN) has been proposed as an acceptable alternative. This meta-analysis aims to evaluate clinical outcomes in patients with periprosthetic supracondylar femoral fractures who were treated with LCP and RIMN. Methods An up-to-date literature search was carried out using the pre-defined search strategy. All studies that met the inclusion criteria were assessed for methodological quality with the Cochrane’s collaboration tool. Operative time, functional score, time-to-union, non-union rates and revision rates were all considered. Conclusion Ten studies with a total of 531 periprosthetic fractures were included. This meta-analysis has suggested that there is no significant difference in any of the outcome measures assessed. Further, more extensive literature is required on the subject to draw more robust conclusions.

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“…Nine articles, totaling 461 fractures, in our study directly compared locked plating and intramedullary nailing. Five articles found no overall advantage to either method, while three articles supported locked plating and one article favored nailing 5,7,13,16,19,20,30,35,41 .…”

Section: Discussionmentioning

confidence: 95%

Periprosthetic Distal Femur Fracture after Total Knee Arthroplasty: A Systematic Review

Ebraheim

Kelley

Liu

et al. 2015

Orthopaedic Surgery

106

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This study was designed to itemize and analyze the classification of fracture types and their corresponding outcomes in an attempt to provide a better understanding of the current treatment methods. Two PubMed searches were performed using the words "periprosthetic distal femur fracture" and "periprosthetic supracondylar femur fracture" in studies that were published in the previous 10 years (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014). Data from 41 articlesthat met the general inclusion criteria, were collected and categorized into fracture type and treatment method groupings. Healing outcome and complications were the two parameters used to analyze the data. Treatment techniques were grouped in the following categories: locking plate, non-locking plate, intramedullary nail/rod, screw, blade plate, cerclage wires, allograft, external fixation, revision arthroplasty, non-operative, and other. Classification systems by Lewis and Rorabeck, the Association for Osteosynthesis/Orthopedic Trauma Association (AO/OTA), Su et al., Neer et al., Kim et al., Backstein et al., and the Société Française de Chirurgie Orthopédique et Traumatologique were reported. In total 448 fractures were identified, of which Rorabeck type II was the most common fracture studied. The two most successful treatment options for periprosthetic distal femur fractures were locking plate (87%) and intramedullary nail/rod (84%). The most frequent complications associated with periprosthetic distal femur fractures included non/mal/delayed union and the need for revision. Locking plates used to treat Rorabeck type II fractures had a complication rate of 35% and those treated with intramedullary nailing had a higher complication rate of 53%. In conclusion, the most frequent type of periprosthetic distal femur fracture after total knee arthroplasty was Rorabeck type II. The most common treatments for these types of fractures are locked plating and intramedullary nailing, with similar healing rates of 87% and 84%, respectively. However, the complication rate for locked plating was lower than for intramedullary nailing.

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Fixation of supracondylar femoral fractures following total knee arthroplasty: is there any difference comparing angular stable plate fixation versus rigid interlocking nail fixation?

Cited by 34 publications

References 15 publications

Distal femoral fractures in the elderly: biomechanical analysis of a polyaxial angle-stable locking plate versus a retrograde intramedullary nail in a human cadaveric bone model

Distal femoral fractures in the elderly: biomechanical analysis of a polyaxial angle-stable locking plate versus a retrograde intramedullary nail in a human cadaveric bone model

Locked compression plating versus retrograde intramedullary nailing in the treatment of periprosthetic supracondylar knee fractures: a systematic review and meta-analysis

Periprosthetic Distal Femur Fracture after Total Knee Arthroplasty: A Systematic Review

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