Periprosthetic Fracture after Total Knee Arthroplasty

Suh, Jeung Tak; Baik, Sang Dai; Chio, Sung Jong

Abstract

PURPOSE: Periprosthetic fracture is known to be uncommon, but serious complication after total knee arthroplasty. We evaluate the clinical outcomes and radiological changes following treatment modality of periprosthetic fracture after total knee arthroplasty.
MATERIALS AND METHODS
We reviewed 13 knees of the 13 patient with periprosthetic fracture after total knee arthroplasty between March 1991 and December 2000 The average follow up period was 27 months. The patient were grouped according to the treatment methods; Group I is the patients who were treated by skeletal traction followed by cast or cast brace. Group II is the patients who were treated by open reduction and internal fixation with plate. Group III is the patients who were treated by retrograde intramedullary nails. We analyse time required for union, femorotibial angle after union, range of motion and Hospital for Special Surgery score of each group.
RESULTS
Time required for union was similliar within groups. Femorotibial angle after union was not significant change in all groups postoperatively. ROM was decreased in Group I but there was not significant changes in group II and III. HSS score was decreased in Group I, 85 preoperatively and 65.2 postoperatively.
CONCLUSION
Skeletal traction followed by cast or cast brace only can be recommended for knees in which the initial alignment and stability of fracture were in acceptab1e range, but it has increased functional loss because of prolonged immobilization and delayed ROM execises. In knees with malaligned and unstable periprosthetic fracture, condylar plating and retrograde IM nails can be recommended for better clinical and radiological results.