Treatment of periprosthetic femoral fractures of the knee

Ehlinger, Matthieu; Adam, P.; Abane, Lamine; Rahmé, Michel; Moor, Beat K.; Arlettaz, Y.; Bonnomet, F.

doi:10.1007/s00167-011-1480-6

Cited by 39 publications

(22 citation statements)

References 34 publications

(113 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Another patient with superficial infection required superficial debridement and antibiotic treatment for a month; so both cases required some local procedures with antibiotics to treat infection and one patient with severe osteoporotic bones had spontaneous periprosthetic un-displaced supracondylar femur fracture which was treated conservatively with plaster. 21,22 Evaluating post operative radiographs, femoral component and tibial component were almost perpendicular to mechanical axis of limb. Patella position was not altered.…”

Section: Discussionmentioning

confidence: 99%

Cruciate retaining versus posterior-stabilized total knee arthroplasty: a short-term comparative study

Suthar¹,

Parekh

Mistry³

2018

Int J Res Orthop

View full text Add to dashboard Cite

Background: Total knee arthroplasty has got excellent results. Among the techniques (posterior-stabilized vs posterior cruciate retaining total knee arthroplasty) it is unclear whether one design has superior outcome over another. The purpose of the present study was to directly compare clinical and radiological outcomes of these two designs.Methods: A prospective study involving 36 patients who received a cruciate-retaining implant were compared to 30 patients who received posterior-stabilized prosthesis. At 3 months follow-up time clinical and radiological evaluation done and results were analyzed.Results: At 3 months follow-up time mean knee society scores improved from 49.9/46.9 (objective/subjective score) points to 80.9/82.5 points in the cruciate-retaining group and from 48.2/43 (objective/subjective score) points to 80.4/80.2 points in the posterior-stabilized group. The ranges of motion was 117.2° (range, 90° to 130°) and 125.3° (range, 100° to 140°) in the cruciate-retaining and posterior-stabilized group respectively, at 3 month follow-up. One patient had post-operatively periprosthetic fracture reported after 2 weeks (treated conservatively), one had superficial infection (treated with dressing) and one patient with superfical infection required debridement.Conclusions: This study did not conclusively demonstrate the superiority of one knee design over the other, suggesting that the choice of implant should be based on surgeon preference, patients knee dimensions, pre-op knee deformity and existing pathology of the posterior cruciate ligament.

show abstract

Section: Discussionmentioning

confidence: 99%

Cruciate retaining versus posterior-stabilized total knee arthroplasty: a short-term comparative study

Suthar¹,

Parekh

Mistry³

2018

Int J Res Orthop

View full text Add to dashboard Cite

show abstract

“…In daily practice, we allow total weight bearing postoperatively as often as possible in order to preserve patient autonomy and decrease bedsore complications [5][6][7]. However, our experience confirms that implant assembly must follow certain guidelines [7,9,10]:…”

Section: Osteosynthesis Guidelinesmentioning

confidence: 68%

“…This surgery combines the mechanical stability and assembly of these plates with the advantages of closed-wound surgery, with preservation of fracture haematoma [2][3][4]. Strict adherence to certain guidelines allows immediate post-operative weight bearing [5,6].…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive surgery with locking plate for periprosthetic femoral fractures: technical note

Ehlinger

Scheibling

Rahmé

et al. 2015

International Orthopaedics (SICOT)

Self Cite

View full text Add to dashboard Cite

show abstract

“…No difference was observed in malunion, nonunion, delayed healing, hardware failure, or infection; thus demonstrating the utility of locking screws in extreme distal PDFF [31]. Importantly, the use of minimally invasive techniques have demonstrated higher union rates, earlier return to pre-injury functional status, and fewer soft-tissue complications [26,32,33].…”

Section: Open Reduction Internal Fixationmentioning

confidence: 86%

Periprosthetic Distal Femur Fractures: Review of Current Treatment Options

Head

2018

ReconRev

View full text Add to dashboard Cite

The geriatric population in general and specifically recipients of total knee arthroplasty (TKA) have increasing functional demands along with an increasing life expectancy. Certain intraoperative aspects of the index procedure, revision TKA, or the patient's physiology (i.e.-osteoporosis, rheumatoid arthritis, neurologic disease) predispose the patient to post-operative periprosthetic distal femur fractures (PDFF). This review describes the epidemiology, classification, examination, and treatment options of PDFF. Osteoporosis and intraoperative anterior femoral cortex notching are primary patient and surgeon specific factors, respectively. The two most commonly used classification systems were described by Rorabeck and Kim and should be used to guide the surgeon's choice of treatment. The non-operative treatment of PDFF is rare, requires close radiographic follow up, and delayed union is common. Open reduction with internal fixation (ORIF) is best accomplished with minimally invasive techniques and distal locking screws. Retrograde, intra-medullary nail fixation is technically difficult, but provides earlier weight bearing and comparable time to union as ORIF. Revision TKA is indicated in patients with adequate bone stock, a simple fracture pattern without ligamentous instability, and a loose or malaligned femoral component. Allograftprosthetic composite (APC) or distal femoral replacement (DFR) is indicated for patients presenting with a PDFF about poor or deficient bone stock. Patients with PDFF present a challenge to the arthroplasty surgeon in regards to choice of treatment and increased morbidity and mortality post-operatively. Close follow up is required and fracture union is often delayed.

show abstract

Treatment of periprosthetic femoral fractures of the knee

Cited by 39 publications

References 34 publications

Cruciate retaining versus posterior-stabilized total knee arthroplasty: a short-term comparative study

Cruciate retaining versus posterior-stabilized total knee arthroplasty: a short-term comparative study

Minimally invasive surgery with locking plate for periprosthetic femoral fractures: technical note

Periprosthetic Distal Femur Fractures: Review of Current Treatment Options

Contact Info

Product

Resources

About