Fracture of the femur after knee arthroplasty

Nielsen, Boe Falkenberg; Petersen, Vivian Stausholm; Varmarken, Jens Erik

doi:10.3109/17453678809169698

Cited by 25 publications

(2 citation statements)

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“…Ultimately, 29 articles were included in this systematic review. A total of 415 fractures that were treated either nonoperatively (Short et al 1981, Sisto et al 1985, Cain et al 1986, Merkel and Johnson 1986, Culp et al 1987, Bogoch et al 1988, Nielsen et al 1988, Cordeiro et al 1990, Garnavos et al 1994, Moran et al 1996, operatively by conventional non-locking plating techniques (Short et al 1981, Sisto et al 1985, Cain et al 1986, Merkel and Johnson 1986, Culp et al 1987, Bogoch et al 1988, Nielsen et al 1988, Cordeiro et al 1990, Healy et al 1993, Zehntner and Ganz 1993, Garnavos et al 1994, Moran et al 1996, Oschner and Pfister 1999, Weber and Peter 1999, Al-Shawi et al 2002, Wang and Wang 2002, Althausen et al 2003, Bezwada et al 2004, retrograde intramedullary nailing (Culp et al 1987, Garnavos et al 1994, McLaren et al 1994, Weber et al 2000, Wick et al 2001, 2004, Althausen et al 2003, Bezwada et al 2004, Gliatis et al 2005, locked submuscular plating techniques (Kregor et al 2001, Althausen et al 2003, Wick...…”

Section: Resultsmentioning

confidence: 99%

Treatment of acute distal femur fractures above a total knee arthroplasty: Systematic review of 415 cases (1981–2006)

et al. 2008

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Background There is no consensus on the best treatment for periprosthetic supracondylar fracture.Material and methods We systematically summarized and compared results of different fixation techniques in the management of acute distal femur fractures above a total knee arthroplasty (TKA). Several databases were searched (Medline, Cochrane library, OTA and AAOS abstract databases) and baseline and outcome parameters were abstracted.Results We extracted data from 29 case series with a total of 415 fractures. The following outcomes were noted: a nonunion rate of 9%, a fixation failure rate of 4%, an infection rate of 3%, and a revision surgery rate of 13%. Retrograde nailing was associated with relative risk reduction (RRR) of 87% (p = 0.01) for developing a nonunion and 70% (p = 0.03) for requiring revision surgery compared to traditional (non-locking) plating methods. Point estimates also suggested risk reductions for locking plates, although these were not statistically significant (57% for nonunion, p = 0.2; 43% for revision surgery, p = 0.23) compared to traditional plating. RRRs for nonunion and revision surgery were also statistically significantly lower for retrograde nailing and locking plates compared to nonoperative treatment.Interpretation Modern-day treatment methods are superior to conventional treatment options in the management of distal femur fractures above TKAs. The results should be interpreted with caution, due to the lack of randomized controlled trials and the possible selection bias in case series.

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Section: Resultsmentioning

confidence: 99%

Treatment of acute distal femur fractures above a total knee arthroplasty: Systematic review of 415 cases (1981–2006)

et al. 2008

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“…Notching of the anterior cortex has been reported as a predisposing factor for a fracture above a knee prosthesis (Merkel and Johnson 1986, Aaron and Scott 1987, Culp et al 1987, Nielsen et al 1988, Healy et al 1993. Those studies do not reveal how many patients had the anterior cortex notched at the time of the knee-replacement operation and the percentage who later suffered a fracture at the notched site.…”

Section: Discussionmentioning

confidence: 99%