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Periprosthetic Fracture in Unicompartmental Knee Arthroplasty

  • Anthony J. Boniello
  • Craig J. Della Valle
  • P. Maxwell Courtney
Chapter

Abstract

Although rare, periprosthetic fractures following unicompartmental knee arthroplasty (UKA) present a treatment dilemma for the orthopedic surgeon. These fractures are most commonly seen of the medial tibial plateau with femoral fractures occurring much less frequently. Patient-related factors such as disorders, which lead to poor bone quality, may predispose to this complication, while stress risers such as those created by the pinholes used to affix the tibial cutting guide, the vertical tibial cut itself, and tibial component sizing and positioning have been proposed as possible mechanisms. Assessing component stability is the key to management of these injuries. Well-fixed components associated with nondisplaced fractures may be managed nonoperatively with a period of protected weight bearing and/or bracing. Displaced fractures with a stable component should be treated with open reduction and internal fixation using a buttress plate for fixation. If the component is loose, revision to a total knee arthroplasty is required and can be technically challenging.

Keywords

Unicompartmental knee arthroplasty Periprosthetic fracture Complications Surgical management Conversion to total knee arthroplasty 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Anthony J. Boniello
    • 1
  • Craig J. Della Valle
    • 2
  • P. Maxwell Courtney
    • 3
  1. 1.Drexel University College of Medicine, Department of OrthopaedicsPhiladelphiaUSA
  2. 2.Adult Reconstruction Division, Department of Orthopaedic Surgery, Rush University Medical CenterChicagoUSA
  3. 3.Rothman Orthopaedic Institute, Thomas Jefferson University HospitalPhiladelphiaUSA

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