Periprosthetic fractures around total knee arthroplasty

S S Sarmah, S Patel, G Reading, M El-Husseiny, S Douglas, F S Haddad, S S Sarmah, S Patel, G Reading, M El-Husseiny, S Douglas, F S Haddad

Abstract

Introduction: The number of total knee arthroplasties performed continues to rise annually and it would be expected that complications, which include periprosthetic fractures, will also therefore become more commonplace. This article reviews the current literature regarding this injury and identifies the treatment principles that enable patients to regain optimal function.

Methods: A comprehensive search of the Pubmed and Embase™ databases was performed to identify relevant articles. Keywords and MeSH (Medical Subject Headings) terms included in the search strategy were 'periprosthetic fracture(s)', 'femur', 'tibia', 'patella(r)', 'complication(s)', 'failure(s)', 'risk(s)', 'prevalence', 'incidence', 'epidemiology' and 'classification(s)'. The search was limited to all articles published in English and reference lists from the original articles were reviewed to identify pertinent articles to include in this review. A total number of 43 studies were identified.

Results: Common treatment aims have been identified when managing patients with a periprosthetic fracture around total knee arthoplasty. The main criterion that determines which option to choose is the degree of remaining bone stock and the amount of fracture displacement.

Conclusions: Treatment of a periprosthetic fracture around total knee arthroplasty will either be non-operative, osteosynthesis or revision arthroplasty. It is imperative that a suitable option is chosen and based on the published literature, pathways are outlined to aid the surgeon.

Figures

Figure 1
Figure 1
Anteroposterior and lateral radiographs sustaining a Lewis and Rorabeck type II periprosthetic fracture
Figure 2
Figure 2
Treatment algorithm for the management of patellar periprosthetic fractures
Figure 3
Figure 3
Treatment algorithm for the management of tibial periprosthetic fractures

References

    1. National Joint Registry for England and Wales 8th Annual Report 2011. Hemel Hempstead: NJR; 2011
    1. Kim KI, Egol KA, Hozack WJ, Parvizi J.Periprosthetic fractures after total knee arthroplasties. Clin Orthop Relat Res 2006; 446: 167–175
    1. Meek RM, Norwood T, Smith Ret al The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement. J Bone Joint Surg Br 2011; 93: 96–101
    1. 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
    1. Merkel KD, Johnson EW.Supracondylar fracture of the femur after total knee arthroplasty. J Bone Joint Surg Am 1986; 68: 29–43
    1. Ritter MA, Faris PM, Keating EM.Anterior femoral notching and ipsilateral supracondylar femur fracture in total knee arthroplasty. J Arthroplasty 1988; 3: 185–187
    1. Ortiguera CJ, Berry DJ.Patellar fracture after total knee arthroplasty. J Bone Joint Surg Am 2002; 84: 532–540
    1. Chalidis BE, Tsiridis E, Tragas AAet al Management of periprosthetic patellar fractures. A systematic review of literature. Injury 2007; 38: 714–724
    1. Grace JN, Sim FH. Fracture of the patella after total knee arthroplasty. Clin Orthop Relat Res 1988; 230: 168–175
    1. Rorabeck CH, Taylor JW. Classification of periprosthetic fractures complicating total knee arthroplasty. Orthop Clin North Am 1999; 30: 209–214
    1. Boyd AD, Ewald FC, Thomas WHet al Long-term complications after total knee arthroplasty with or without resurfacing of the patella. J Bone Joint Surg Am 1993; 75: 674–681
    1. Felix NA, Stuart MJ, Hanssen AD. Periprosthetic fractures of the tibia associated with total knee arthroplasty. Clin Orthop Relat Res 1997; 345: 113–124
    1. Bezwada HP, Neubauer P, Baker Jet al Periprosthetic supracondylar femur fractures following total knee arthroplasty. J Arthroplasty 2004; 19: 453–458
    1. Lesh ML, Schneider DJ, Deol Get al The consequences of anterior femoral notching in total knee arthroplasty. A biomechanical study. J Bone Joint Surg Am 2000; 82: 1,096–1,101
    1. Zalzal P, Backstein D, Gross AE, Papini M. Notching of the anterior femoral cortex during total knee arthroplasty characteristics that increase local stresses. J Arthroplasty 2006; 21: 737–743
    1. Shawen SB, Belmont PJ, Klemme WRet al Osteoporosis and anterior femoral notching in periprosthetic supracondylar femoral fractures: a biomechanical analysis. J Bone Joint Surg Am 2003; 85: 115–121
    1. Ritter MA, Thong AE, Keating EMet al The effect of femoral notching during total knee arthroplasty on the prevalence of postoperative femoral fractures and on clinical outcome. J Bone Joint Surg Am 2005; 87: 2,411–2,414
    1. Gujarathi N, Putti AB, Abboud RJet al Risk of periprosthetic fracture after anterior femoral notching. Acta Orthop 2009; 80: 553–556
    1. Sheth NP, Pedowitz DI, Lonner JH. Periprosthetic patellar fractures. J Bone Joint Surg Am 2007; 89: 2,285–2,296
    1. Stoffel KK, Flivik G, Yates PJ, Nicholls RL. Intraosseous blood flow of the everted or laterally-retracted patella during total knee arthroplasty. Knee 2007; 14: 434–438
    1. Kayler DE, Lyttle D. Surgical interruption of patellar blood supply by total knee arthroplasty. Clin Orthop Relat Res 1988; 229: 221–227
    1. Dennis DA. Periprosthetic fractures following total knee arthroplasty. Instr Course Lect 2001; 50: 379–389
    1. Lewis PL, Rorabeck CH. Periprosthetic Fractures. In: Engh GA, Rorabeck CH, eds. Revision Total Knee Arthroplasty. Baltimore: Lippincott Williams & Wilkins; 1997
    1. Platzer P, Schuster R, Aldrian Set al Management and outcome of periprosthetic fractures after total knee arthroplasty. J Trauma 2010; 68: 1,464–1,470
    1. Figgie MP, Goldberg VM, Figgie HE, Sobel M. The results of treatment of supracondylar fracture above total knee arthroplasty. J Arthroplasty 1990; 5: 267–276
    1. Cain PR, Rubash HE, Wissinger HA, McClain EJ. Periprosthetic femoral fractures following total knee arthroplasty. Clin Orthop Relat Res 1986; 208: 205–214
    1. Herrera DA, Kregor PJ, Cole PAet al Treatment of acute distal femur fractures above a total knee arthroplasty: systematic review of 415 cases (1981–2006). Acta Orthop 2008; 79: 22–27
    1. Althausen PL, Lee MA, Finkemeier CGet al Operative stabilization of supracondylar femur fractures above total knee arthroplasty: a comparison of four treatment methods. J Arthroplasty 2003; 18: 834–839
    1. Large TM, Kellam JF, Bosse MJet al Locked plating of supracondylar periprosthetic femur fractures. J Arthroplasty 2008; 23(6 Suppl 1): 115–120
    1. Bong MR, Egol KA, Koval KJet al Comparison of the LISS and a retrograde-inserted supracondylar intramedullary nail for fixation of a periprosthetic distal femur fracture proximal to a total knee arthroplasty. J Arthroplasty 2002; 17: 876–881
    1. Beris AE, Lykissas MG, Sioros Vet al Femoral periprosthetic fracture in osteoporotic bone after a total knee replacement: treatment with Ilizarov external fixation. J Arthroplasty 2010; 25: 1168.e9–e12
    1. Simon RG, Brinker MR.Use of Ilizarov external fixation for a periprosthetic supracondylar femur fracture. J Arthroplasty 1999; 14: 118–121
    1. Hurson C, Synnott K, McCormack D. Above-knee Ilizarov external fixation for early periprosthetic supracondylar femoral fracture – a case report. Knee 2005; 12: 145–147
    1. Srinivasan K, Macdonald DA, Tzioupis CC, Giannoudis PV. Role of long stem revision knee prosthesis in periprosthetic and complex distal femoral fractures: a review of eight patients. Injury 2005; 36: 1,094–1,102
    1. Mortazavi SM, Kurd MF, Bender Bet al Distal femoral arthroplasty for the treatment of periprosthetic fractures after total knee arthroplasty. J Arthroplasty 2010; 25: 775–780
    1. Kassab M, Zalzal P, Azores GMet al Management of periprosthetic femoral fractures after total knee arthroplasty using a distal femoral allograft. J Arthroplasty 2004; 19: 361–368
    1. Backstein D, Safir O, Gross A. Management of bone loss: structural grafts in revision total knee arthroplasty. Clin Orthop Relat Res 2006; 446: 104–112
    1. 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
    1. Keating EM, Haas G, Meding JB. Patella fracture after post total knee replacements. Clin Orthop Relat Res 2003; 416: 93–97
    1. Hozack WJ, Goll SR, Lotke PAet al The treatment of patellar fractures after total knee arthroplasty. Clin Orthop Relat Res 1988; 236: 123–127
    1. Sisto DJ, Lachiewicz PF, Insall JN. Treatment of supracondylar fractures following prosthetic arthroplasty of the knee. Clin Orthop Relat Res 1985; 196: 265–272
    1. Culp RW, Schmidt RG, Hanks Get al Supracondylar fracture of the femur following prosthetic knee arthroplasty. Clin Orthop Relat Res 1987; 222: 212–222
    1. Moran MC, Brick GW, Sledge CBet al Supracondylar femoral fracture following total knee arthroplasty. Clin Orthop Relat Res 1996; 324: 196–209

Source: PubMed

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