Operative Results of Periprosthetic Fractures of The Distal Femur In A Single Academic Unit

Leino, Oskari K; Lempainen, Lasse; Virolainen, Petri; Sarimo, Janne; Pölönen, Tuukka; Mäkelä, Keijo

doi:10.1177/1457496914552343

Cited by 30 publications

(22 citation statements)

References 15 publications

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“…Kurowicki et al (37) treated a series of 7 humeral PF (type B according to Wright and Cofield classification) using a locking plate with eccentrically placed screw holes; they reported a 100% union rate and excellent pain relief (mean visual analogic score of 0.5) at an average follow-up of 29 weeks. In Type B2 fractures the implant is loose but bone stock is preserved, and revision surgery is the preferred treatment choice (27,(38)(39)(40)(41) …”

Section: Classification Management and Resultsmentioning

confidence: 99%

Periprosthetic fractures: epidemiology and current treatment

Capone

Congia

Civinini

et al. 2017

ccmbm

111

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SummaryPeriprosthetic fractures are becoming increasingly frequent due to aging population and growing number of total joint replacements involving joints different from hip and knee, such as shoulder and elbow. The treatment of these fractures still represents one of the major challenges for the orthopedic surgeon. Despite all efforts to understand and treat these patients, high rate of failure and mortality are still reported. In this review, the epidemiology of periprosthetic fractures, risk factors and results of surgical treatment are disclosed. Moreover, we propose a treatment algorithm based on the findings of the New Unified Classification System.

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Section: Classification Management and Resultsmentioning

confidence: 99%

Periprosthetic fractures: epidemiology and current treatment

Capone

Congia

Civinini

et al. 2017

ccmbm

111

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“…Periprosthetic fractures are major complications and mostly require a challenging operative treatment with high post‐operative complication rates including, e.g., infections, non‐union and early loosening, resulting in the need for further revision surgery (Herrera et al., ; Leino et al., ).…”

Section: Discussionmentioning

confidence: 99%

Alpine Skiing With total knee ArthroPlasty (ASWAP): clinical and radiographic outcomes

Hofstaedter¹,

Fink²,

Dorn³

et al. 2015

Scandinavian Med Sci Sports

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The aim of the study was to assess the effect of a recreational alpine skiing intervention on implant-related factors, such as loosening and wear, in patients with total knee arthoplasty (TKA). A group of 16 TKA patients were examined 2.3 ± 0.1 years after skiing about 80 days over three seasons inclusive of a ski intervention of 2-3 times per week (25.5 days) over a 12-week period. Mean follow-up period was 5.1 ± 1 years after surgery. All patients had excellent clinical and radiological outcomes. The average flexion was 120-130°, the average Oxford Knee Score increased from 15 points pre-operatively to 47.4 points post-operatively. An average Tegner activity level of 5.5 was assessed, indicating a very high post-operative activity level. No radiolucencies or osteolyses were observed in any of the radiographs. One patient sustained a meniscal tear in the contralateral knee. Recreational alpine skiing on intermediate terrain at moderate speed can be recommended after TKA. Analysis of mid-term follow-up has not shown any negative effect on the implant loosening or additional polyethylene wear.

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“…However, TKA can cause various complications such as aseptic loosening, infection, and periprosthetic fractures that are particularly in elderly patients. [8][9][10] More importantly, El-Galaly et al 11 has found that previous fractures in the distal femur and/or proximal tibia can increase the risk of early and medium-term revision of TKAs inserted, and the revision due to instability occurred more frequently in TKAs performed as a result of previous fractures. New retrograde nails have developed to increase stability, and biomechanical cadaveric studies showed that they even had a better performance in terms of fatigue resistance in younger patients, however, in elderly individuals with poor bone quality, it's unsuccessful because such patients have reduced bone volumes and weaker bones as well as joint distortion due to arthritis, in the condition their bones offer little purchase to nails.…”

Section: Discussionmentioning

confidence: 99%

The Old Supracondylar Fracture of Femur Treated by Gradual Deformity Correction Using the Ilizarov Technique Followed by the Second-Stage Internal Fixation in an Elderly Patient With Osteoporosis

Hou

Zhang

Bai

et al. 2020

Geriatr Orthop Surg Rehabil

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Background: The supracondylar nonunion of femur in elderly individuals is rare and challenging to manage. Nothing in English literatures or guidelines is available regarding this particular fracture characterized by osteoporosis, soft-tissue contracture, shortening, and joint stiffness. We report a case of an elderly patient with a supracondylar nonunion of the femur, which was successfully treated using staged Ilizarov techniques and dual plating. Case Presentation: An 84-year-old female patient was admitted to our orthopedic department for her pain and soft-tissue swelling around the right knee with claudication and shortening deformity of the affected extremity. She denied any specific history of trauma and had sought traditional Chinese medical attention for 6 months before she presented to our hospital. Diagnosis of the right femoral supracondylar nonunion was made based on the X-ray and computed tomography. Ilizarov external fixator was carried out for successive and slow distraction and gradual correction of the shortening deformity, in consideration of the nonunion was still present. Subsequently, internal fixation with dual plating of the distal femur was performed. Excellent function and patient satisfaction were observed at 6 months of follow-up. Conclusion: The protocol of Ilizarov technique with subsequent internal fixation of dual plating seems to be an efficient solution to the supracondylar nonunion of femur in elderly patients with osteoporosis. The advantage of the protocol is that it allows knee joint motion, avoids neurovascular complications, and gentle correction of soft-tissue contractures.

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Operative Results of Periprosthetic Fractures of The Distal Femur In A Single Academic Unit

Abstract: Post-operative surgical site complications were relatively common in these mainly elderly female patients. The survival percentages of the re-arthroplasty and laminofixation groups were similar. The use of strut grafts in association with plating may decrease re-operation rate.

Cited by 30 publications

References 15 publications

Periprosthetic fractures: epidemiology and current treatment

Periprosthetic fractures: epidemiology and current treatment

Alpine Skiing With total knee ArthroPlasty (ASWAP): clinical and radiographic outcomes

The Old Supracondylar Fracture of Femur Treated by Gradual Deformity Correction Using the Ilizarov Technique Followed by the Second-Stage Internal Fixation in an Elderly Patient With Osteoporosis

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