J Korean Fract Soc.  2011 Oct;24(4):382-387.

Revision Total Knee Arthroplasty in the Treatment of Periprosthetic Fracture around the Knee

• Kim KI
• Cho KY
• Kang D

Abstract

No abstract available.

MeSH Terms

Arthroplasty
Knee
Periprosthetic Fractures

Figure

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  Fig. 1 (A, B) Initial radiographs show a type II periprosthetic femoral fracture with a very distal location. Intraoperatively, the loose femoral component was recognized and was needed to be revised. (C, D) Since the tibial component was stable, only the femoral side was revised using a long stem component which was cemented to the metaphysic and press fit into the diaphysis.

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  Fig. 2 (A, B) Initial radiographs show a type III periprosthetic femoral fracture in an 82 years old female with severe osteoporosis. A distal femoral replacement was performed because of small size and poor bone quality of the distal fragement. Also since the tibial component was malpositioned (varus fitting) tibial revision was performed simultaneously. (C, D) After a distal femoral replacement postoperative radiographs show good alignment.

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  Fig. 3 (A) Anteroposterior and lateral radiographs show a type IIB periprosthetic tibial fracture. Severe osteolysis around tibial stem is observed. (B) Revision arthroplasty with a cemented long stem component was performed. (C) After 6 years postoperatively the followup radiographs show healed fracture site.

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  Fig. 4 (A) Initial radiographs show a type IVB periprosthetic tibial fracture with component loosening. (B) This fracture was treated with revision arthroplasty using constrained prosthesis and cerclage wiring of the tibial tubercle.

Reference

1. Berry DJ. Epidemiology: hip and knee. Orthop Clin North Am. 1999. 30:183–190.

2. Cordeiro EN, Costa RC, Carazzato JG, Silva Jdos S. Periprosthetic fractures in patients with total knee arthroplasties. Clin Orthop Relat Res. 1990. 252:182–189.

3. Culp RW, Schmidt RG, Hanks G, Mak A, Esterhai JL Jr, Heppenstall RB. Supracondylar fracture of the femur following prosthetic knee arthroplasty. Clin Orthop Relat Res. 1987. 222:212–222.

4. Della Valle CJ, Haidukewych GJ, Callaghan JJ. Periprosthetic fractures of the hip and knee: a problem on the rise but better solutions. Instr Course Lect. 2010. 59:563–575.

5. Dorr LD. Fractures following total knee arthroplasty. Orthopedics. 1997. 20:848–850.

6. Engh GA, Ammeen DJ. Periprosthetic fractures adjacent to total knee implants: treatment and clinical results. Instr Course Lect. 1998. 47:437–448.

7. Felix NA, Stuart MJ, Hanssen AD. Periprosthetic fractures of the tibia associated with total knee arthroplasty. Clin Orthop Relat Res. 1997. 345:113–124.

8. Figgie MP, Goldberg VM, Figgie HE 3rd, Sobel M. The results of treatment of supracondylar fracture above total knee arthroplasty. J Arthroplasty. 1990. 5:267–276.

9. Ghazavi MT, Stockley I, Yee G, Davis A, Gross AE. Reconstruction of massive bone defects with allograft in revision total knee arthroplasty. J Bone Joint Surg Am. 1997. 79:17–25.

10. Healy WL, Siliski JM, Incavo SJ. Operative treatment of distal femoral fractures proximal to total knee replacements. J Bone Joint Surg Am. 1993. 75:27–34.

11. Hirsh DM, Bhalla S, Roffman M. Supracondylar fracture of the femur following total knee replacement. Report of four cases. J Bone Joint Surg Am. 1981. 63:162–163.

12. Inglis AE, Walker PS. Revision of failed knee replacements using fixed-axis hinges. J Bone Joint Surg Br. 1991. 73:757–761.

13. Keenan J, Chakrabarty G, Newman JH. Treatment of supracondylar femoral fracture above total knee replacement by custom made hinged prosthesis. Knee. 2000. 7:165–170.

14. Kim KI, Egol KA, Hozack WJ, Parvizi J. Periprosthetic fractures after total knee arthroplasties. Clin Orthop Relat Res. 2006. 446:167–175.

15. Kraay MJ, Goldberg VM, Figgie MP, Figgie HE 3rd. Distal femoral replacement with allograft/prosthetic reconstruction for treatment of supracondylar fractures in patients with total knee arthroplasty. J Arthroplasty. 1992. 7:7–16.

16. Lotke PA, Ecker ML. Influence of positioning of prosthesis in total knee replacement. J Bone Joint Surg Am. 1977. 59:77–79.

17. McLaren AC, Dupont JA, Schroeber DC. Open reduction internal fixation of supracondylar fractures above total knee arthroplasties using the intramedullary supracondylar rod. Clin Orthop Relat Res. 1994. 302:194–198.

18. Meek RM, Norwood T, Smith R, Brenkel IJ, Howie CR. The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement. J Bone Joint Surg Br. 2011. 93:96–101.

19. Merkel KD, Johnson EW Jr. Supracondylar fracture of the femur after total knee arthroplasty. J Bone Joint Surg Am. 1986. 68:29–43.

20. Mortazavi SM, Kurd MF, Bender B, Post Z, Parvizi J, Purtill JJ. Distal femoral arthroplasty for the treatment of periprosthetic fractures after total knee arthroplasty. J Arthroplasty. 2010. 25:775–780.

21. Parvizi J, Jain N, Schmidt AH. Periprosthetic knee fractures. J Orthop Trauma. 2008. 22:663–671.

22. Rand JA, Coventry MB. Stress fractures after total knee arthroplasty. J Bone Joint Surg Am. 1980. 62:226–233.

23. Ritter MA, Faris PM, Keating EM. Anterior femoral notching and ipsilateral supracondylar femur fracture in total knee arthroplasty. J Arthroplasty. 1988. 3:185–187.

24. Rorabeck CH, Taylor JW. Classification of periprosthetic fractures complicating total knee arthroplasty. Orthop Clin North Am. 1999. 30:209–214.

25. Rorabeck CH, Taylor JW. Periprosthetic fractures of the femur complicating total knee arthroplasty. Orthop Clin North Am. 1999. 30:265–277.

26. Schrøder HM, Berthelsen A, Hassani G, Hansen EB, Solgaard S. Cementless porous-coated total knee arthroplasty: 10-year results in a consecutive series. J Arthroplasty. 2001. 16:559–567.

27. Springer BD, Sim FH, Hanssen AD, Lewallen DG. The modular segmental kinematic rotating hinge for nonneoplastic limb salvage. Clin Orthop Relat Res. 2004. 421:181–187.

28. Thompson NW, McAlinden MG, Breslin E, Crone MD, Kernohan WG, Beverland DE. Periprosthetic tibial fractures after cementless low contact stress total knee arthroplasty. J Arthroplasty. 2001. 16:984–990.

29. Wong P, Gross AE. The use of structural allografts for treating periprosthetic fractures about the hip and knee. Orthop Clin North Am. 1999. 30:259–264.