Periprosthetic Fractures in Total Knee Arthroplasty

Alencar, Paulo Gilberto Cimbalista de; Bortoli, Giovani De; Vieira, Inácio Facó Ventura; Uliana, Christiano Saliba

doi:10.1016/s2255-4971(15)30362-1

Cited by 4 publications

(6 citation statements)

References 32 publications

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“…After a mean follow-up of 34 months, the Knee Society Score and Range of Motion were measured and their analysis showed that there was no impact on the outcome based on fracture type or treatment method. However, a significant correlation was revealed by the study, between the functional outcome (measured by the Knee Society Score) and the quality of life (evaluated with Short Form Health Survey [36], a selfadministered questionnaire).…”

Section: Articles Covering Femoral and Tibial Fractures After Tkamentioning

confidence: 81%

“…One of the most recent studies in our database was published in 2019, by Karam et al [36]. The authors focused on an uncovered topic in previous articles: the comparison between prosthetic and non-prosthetic femoral fractures, treated with locking plates, based on risk factors and postoperative outcome.…”

Section: New Perspectives On Periprosthetic Femoral Fracturesmentioning

confidence: 99%

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Periprosthetic fractures after total knee arthroplasty: review

Creţu

Șerban

Zaharia

et al. 2019

Romanian Journal of Orthopaedic Surgery and Traumatology

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This review of literature classifies and describes the most common periprosthetic fractures after total knee arthroplasty. Classification systems are usually considered useful when they describe the condition and offer guidelines for the management of a certain condition and are specific and comprehensive. The Lewis and Rorabeck classification can be used to describe these fractures. The review not only provides the results of the classic techniques, but also new and combined techniques tried by some of the authors. For this review, only original studies, published between 2013 and 2019, were selected. The articles included in the database were selected from PubMed, ScienceDirect and SpringerLink. The searched keywords used to identify the articles were TKA, periprosthetic fractures and total knee arthroplasty. The aim of this paper was to review the clinical studies related to periprosthetic fractures after total knee arthroplasty from the last six years, in order to understand current perspectives, epidemiology, treatment, and management.In conclusion, periprosthetic fractures after total knee arthroplasty represent an important problem in medicine, but due to the low number of cases. Despite the increase in incidence, guidelines are mostly based on retrospective studies, personal observations, and expert opinion. The consensus is that treatment should be assigned depending on the patient's profile and the fracture's characteristics. Further studies should be performed in order to guide future practitioners in the treatment of periprosthetic fractures.

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Section: Articles Covering Femoral and Tibial Fractures After Tkamentioning

confidence: 81%

Section: New Perspectives On Periprosthetic Femoral Fracturesmentioning

confidence: 99%

Periprosthetic fractures after total knee arthroplasty: review

Creţu

Șerban

Zaharia

et al. 2019

Romanian Journal of Orthopaedic Surgery and Traumatology

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“…However, not all surgeons have the expertise, training, and facilities to perform this microsurgical procedure, which limits its use in many trauma situations. Other good options, like allogenic bone grafts and bone graft substitutes, also have limited use mainly due to its high cost [ 11 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…The associated use of autograft has been proposed as an osteogenic stimulus with good results reported [ 4 , 6 , 7 , 11 , 13 , 15 ]. Those authors describe the use of cancellous bone graft for augmentation of the fibular graft and speeding up the healing process.…”

Section: Discussionmentioning

confidence: 99%

Use of Nonvascularized Autologous Fibular Strut Graft in the Treatment of Major Bone Defect after Periprosthetic Knee Fracture

Giordano

Coutinho

Miyahira

et al. 2017

Case Reports in Orthopedics

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We present the case of a patient who suffered a comminuted supracondylar periprosthetic femur fracture. The patient was an 86-year-old lady who suffered a minor fall at home and presented at our hospital with a right comminuted distal femur fracture around a total knee arthroplasty. The patient was submitted to a cruciate-sacrificing total knee replacement 6 years before at the same institution. Despite severe metaphyseal fragmentation and short distal fragment, the prosthesis was stable; thus, open fracture reduction and stabilization with internal fixation were performed. The surgical technique included the use of a nonvascularized autologous fibular strut graft as an augmentation technique in conjunction with double plating fixation. Clinically, patient presented a painless aligned knee 12 months after femur fixation, although she was not able to return to an independent level of activity. No pain involving the donor graft site was reported at the time of the most recent follow-up examination. This case study demonstrates the use of free nonvascularized autogenous fibular strut bone graft as an option to bridge major bone defects. This proved to be a relatively simple, not expensive procedure that can be done percutaneously and does not need high-quality training.

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“…The advantages of this technique over vascularised autografts are easier operative procedure, shorter operative time and remodeling capacity at the donor site. 3,4 Application of dynamic compression plates (DCP) has been suggested in the fracture of the shaft of femur as it allows early mobilization. However fracture of the shaft of femur with segmental bone loss required an augmentation technique, cortical strut graft used as increasing mechanical strength of the site of the fracture.…”

Section: Introductionmentioning

confidence: 99%

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We present the case of a patient who suffered a comminuted femoral shaft fracture. The patient was a 20 years-old male following a sustained RTA and presented at our hospital after about 6 weeks after the incidence. Initially he was treated with skeletal traction with surgical toileting and debridement; and later on external fixator with dressing several times. Open reduction and internal fixation was performed with the use of a non-vascularized autologous fibular strut graft as an augmentation technique in conjunction with dynamic plating. Bony union occurred at 24 weeks. Clinically patient had stable, painless extremity, and resumed active use of the involved extremity without protective device after 2 year after femur fixation. No pain involving the donor graft site was reported at the time of the most recent follow-up examination. This case study demonstrates the use of free nonvascularized autogenous fibular strut bone graft as an option to bridge segmental bone loss in comminuted femoral shaft fracture. This is a relatively simple, not expensive procedure.

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Periprosthetic Fractures in Total Knee Arthroplasty

Cited by 4 publications

References 32 publications

Periprosthetic fractures after total knee arthroplasty: review

Periprosthetic fractures after total knee arthroplasty: review

Use of Nonvascularized Autologous Fibular Strut Graft in the Treatment of Major Bone Defect after Periprosthetic Knee Fracture

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