The Outcome and Complications of the Locked Plating Management for the Periprosthetic Distal Femur Fractures after a Total Knee Arthroplasty

Abstract

BackgroundThe osteosynthesis of the periprosthetic fractures following a total knee arthroplasty (TKA) can be technically difficult with the relatively small satisfactory outcomes and the high complication rates. The purpose of the study is to analyze the mid-term radiological and functional outcomes following the locked plating of the distal femur periprosthetic fractures after a TKA.MethodsRecords of 20 patients with a periprosthetic distal femur fracture following TKA treated by the locked plate osteosynthesis were retrospectively evaluated. The union rate, complications and functional outcome measures were analyzed.ResultsSuccessful union was achieved in 18 of the 19 patients available for the follow-up. The mean follow-up was 39 ± 10 months. Significant reductions (p < 0.05) in the range of motion and Western Ontario and McMaster Universities Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were evident in the follow-up. Secondary procedures were required in 5 patients to address the delay in union and the reduced knee range of motion. The osteosynthesis failed in 1 patient who underwent a revision TKA.ConclusionsThe satisfactory union rates can be achieved with the locked plate osteosynthesis in the periprosthetic distal femur fractures after TKA. Prolonged rehabilitation coupled with the un-modifiable risk factors can decrease the activity and satisfaction levels, which can significantly alter the functional outcome.

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An alternative treatment for osteoporotic Su Type III periprosthetic supracondylar femur fractures: Double locking plate fixation

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Femoral Periprosthetic Fractures after Total Knee Arthroplasty: New Surgically Oriented Classification with a Review of Current Treatments

“…On the basis of continuing reports of superior treatment results with LCP or RIMN, we believe that conservative treatment should no longer be an option for the treatment of femoral periprosthetic fractures, even nondisplaced fractures 29 – 38) . Considering the demographic background of patients including their advanced age and rapid deterioration of general condition due to prolonged bed rest, conservative treatment should be removed from the directory of treatment options for femoral periprosthetic fractures, except for unavoidable cases.…”