J Korean Fract Soc.  2012 Jan;25(1):1-7. 10.12671/jkfs.2012.25.1.1.

Risk Factors of Periprosthetic Fracture after Total Knee Arthroplasty

• Shin JY
• Kim HJ
• Cha SH
• Kim DH

• KMID: 1434103
• DOI: http://doi.org/10.12671/jkfs.2012.25.1.1

Abstract

PURPOSE
To evaluate the incidence rate and risk factors for periprosthetic fracture after total knee replacement (TKR).
MATERIALS AND METHODS
We carried out a retrospective case-control study of 596 patients (951 knees) who underwent TKR between 1999 and 2006 and who were followed up over 36 months. We classified patients into group I (study group) and group II (control group). We subdivided risk factors as pre-operative, intra-operative, and post-operative factors. Age, osteoporosis, revision arthroplasty, CVA, and alcohol dependence were categorized as pre-operative factors; anterior femoral notching and prosthetic types (mobile, fixed, and load-bearing) were considered intra-operative factors; and post-operative activity level was classified as a post-operative factor. We obtained information from the patients' charts, X-ray film, and telephone interviews.
RESULTS
The overall incidence rate was 2.25%; 3 patients were male, and 18 were female (14.28% and 85.72%, respectively). Old age (p<0.01, odds ratio=1.14), osteoporosis (p=0.01, odds ratio=4.74), revision arthroplasty (p=0.01, odds ratio=7.46), CVA (p=0.02, odds ratio=8.55), and alcohol dependence (p=0.03, odds ratio=44.54) were statistically significant among the pre-operative factors. Among the intra-operative factors, anterior femoral notching (p<0.01, odds ratio=11.74) was significant, and continued heavy labor (p<0.01, odds ratio=8.14) was significant among the post-operative factors.
CONCLUSION
We concluded that old age, osteoporosis, revision arthroplasty, comorbidity related with falling down, anterior femoral notching, and continued heavy labor were associated with periprosthetic fracture after TKR.

Keyword

Risk factor; Periprosthetic fracture; Total knee replacement

MeSH Terms

Alcoholism
Arthroplasty
Arthroplasty, Replacement, Knee
Case-Control Studies
Comorbidity
Female
Humans
Incidence
Knee
Male
Osteoporosis
Periprosthetic Fractures
Retrospective Studies
Risk Factors
Telephone
X-Ray Film

Figure

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  Fig. 1 (A) Tansverse sections of the distal femur showing notching. (B) Sagittal section of the distal femur demonstrating grade III and IV notching.

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