Periprosthetic fractures associated with total knee arthroplasty

Konan, Sujith; Sandiford, Nemandra A; Unno, Florence; Masri, B A; Garbuz, Donald S.; Duncan, Clivе P.

doi:10.1302/0301-620x.98b11.bjj-2016-0029.r1

Cited by 50 publications

(28 citation statements)

References 56 publications

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“…der proximalen Tibia vor dem Hintergrund des dargestellten Patientengutes vor. Aktuelle Reviews empfehlen des Weiteren die einheitliche Verwendung des UCS anstelle der verschiedenen bekannten Klassifikationssysteme [28,36]. Es zeigt sich sowohl in unserer Studie als auch in Zusammenschau der Literatur, dass die Versorgung PpFxK von einer relativ hohen Komplikationsrate begleitet ist, das Kollektiv oftmals voroperiert ist und sich in einem anspruchsvollen Gesamtkontext präsentiert.…”

Section: Diskussionunclassified

Adverse Events in the Treatment of Periprosthetic Fractures Around the Knee – a Clinical and Radiological Outcome Analysis

et al. 2018

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PpFxK are severe injuries and are associated with a high rate of adverse events related to treatment. Patients often have a complex background and a history of revision surgery or periprosthetic joint infection. The treatment of PpFxK should therefore take place at a centre with expertise in traumatology as well as in revision arthroplasty. Preoperative infection diagnostic testing as well as adequate imaging (X-rays and CT) are essential. We furthermore advise early evaluation of revision arthroplasty, especially in elderly patients suffering from PpFxK with insufficient bone quality around the TKA and closeness between fracture and TKA. In the case of plate fixation, it is important to give attention to correct reduction - to prevent non-union, loosening of the implant and failure of the osteosynthesis - as well as to consider double plating.

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Section: Diskussionunclassified

Adverse Events in the Treatment of Periprosthetic Fractures Around the Knee – a Clinical and Radiological Outcome Analysis

et al. 2018

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“…The aims of surgical treatment are to achieve stable anatomical reduction allowing for analgesia, ease of care, and early mobilization [6, 7]. These fractures have been shown to have problematic healing, with reported non-union rates of 6–25% [8, 9].…”

Section: Introductionmentioning

confidence: 99%

Comparison of outcomes and analysis of risk factors for non-union in locked plating of closed periprosthetic and non-periprosthetic distal femoral fractures in a retrospective cohort study

et al. 2019

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Background The primary aim was to compare the outcomes of locked plating of closed distal femur periprosthetic and non-periprosthetic fractures by testing the hypothesis that outcomes would be worse in the periprosthetic group. The secondary aim of this study was to identify risk factors for non-union. Methods A single-center study over an 8-year period utilizing a retrospective cohort design was performed. Sixty-eight patients with periprosthetic fractures and 57 patients with non-periprosthetic fractures met inclusion criteria for the study. There was a significant difference between groups in mean age (80.1 years periprosthetic vs. 70.9 years non-periprosthetic ( p < 0.001)). Statistical analysis between groups was used to assess the outcomes of time to union, incidence of non-union, post-operative functionality, incidence of complications, progression to revision surgery, and mortality. A secondary multivariable analysis was used to assess risk factors for non-union and factors positively associated with union. Results There were no significant differences in outcomes between groups. Union rates were 83.8% (57/68) in the periprosthetic group and 78.9% (45/57) in the non-periprosthetic group ( p = 0.648). Comminution was identified as a significant risk factor for non-union ( p = 0.005). Use of a submuscular technique had a significant positive association with union ( p = 0.006). Conclusions Outcomes of surgical treatment for periprosthetic and non-periprosthetic distal femur fractures are similar. There is a significant risk of non-union in locked plating of both groups.

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“… 8 Femoral and tibial overhang may cause increased pain and impingement of the soft tissue. 9 - 11 In contrast, femoral and tibial resection underhang contributes to component loosening and subsidence. 3 , 7 , 12 …”

Section: Introductionmentioning

confidence: 99%

Patient-specific medial unicompartmental knee arthroplasty has a greater protective effect on articular cartilage in the lateral compartment

Suh

et al. 2018

Bone & Joint Research

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ObjectivesPatient-specific (PS) implantation surgical technology has been introduced in recent years and a gradual increase in the associated number of surgical cases has been observed. PS technology uses a patient’s own geometry in designing a medical device to provide minimal bone resection with improvement in the prosthetic bone coverage. However, whether PS unicompartmental knee arthroplasty (UKA) provides a better biomechanical effect than standard off-the-shelf prostheses for UKA has not yet been determined, and still remains controversial in both biomechanical and clinical fields. Therefore, the aim of this study was to compare the biomechanical effect between PS and standard off-the-shelf prostheses for UKA.MethodsThe contact stresses on the polyethylene (PE) insert, articular cartilage and lateral meniscus were evaluated in PS and standard off-the-shelf prostheses for UKA using a validated finite element model. Gait cycle loading was applied to evaluate the biomechanical effect in the PS and standard UKAs.ResultsThe contact stresses on the PE insert were similar for both the PS and standard UKAs. Compared with the standard UKA, the PS UKA did not show any biomechanical effect on the medial PE insert. However, the contact stresses on the articular cartilage and the meniscus in the lateral compartment following the PS UKA exhibited closer values to the healthy knee joint compared with the standard UKA.ConclusionThe PS UKA provided mechanics closer to those of the normal knee joint. The decreased contact stress on the opposite compartment may reduce the overall risk of progressive osteoarthritis.Cite this article: K-T. Kang, J. Son, D-S. Suh, S. K. Kwon, O-R. Kwon, Y-G. Koh. Patient-specific medial unicompartmental knee arthroplasty has a greater protective effect on articular cartilage in the lateral compartment: A Finite Element Analysis. Bone Joint Res 2018;7:20–27. DOI: 10.1302/2046-3758.71.BJR-2017-0115.R2.

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Periprosthetic fractures associated with total knee arthroplasty

Cited by 50 publications

References 56 publications

Adverse Events in the Treatment of Periprosthetic Fractures Around the Knee – a Clinical and Radiological Outcome Analysis

Adverse Events in the Treatment of Periprosthetic Fractures Around the Knee – a Clinical and Radiological Outcome Analysis

Comparison of outcomes and analysis of risk factors for non-union in locked plating of closed periprosthetic and non-periprosthetic distal femoral fractures in a retrospective cohort study

Patient-specific medial unicompartmental knee arthroplasty has a greater protective effect on articular cartilage in the lateral compartment

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