Advertisement

Management of Periprosthetic Fractures Around a Total Knee Arthroplasty with a Loose Femoral Component

  • Michael Suk
  • Michael R. Rutter
Chapter

Abstract

Periprosthetic distal femur fractures (PDFF) are complex problems for the surgeon with the potential for significant complications. The incidence of PDFF has been reported to be between 0.3% and 2.5%. While fixation remains the mainstay in a stable component, revision or use of a distal femoral replacement (DFR) may be required in the setting of a loose component with or without bone loss. The goal of treatment of PDFF is to provide the patient with a stable, painless knee and to minimize malalignment, and in this chapter, we will review the pertinent points to address during the work-up, planning, and execution of operative treatment of PDFF about a loose component.

Keywords

Periprosthetic fracture Femur Knee Loose total knee arthroplasty Revision total knee arthroplasty 

References

  1. 1.
    DiGioia AM, Rubash HE. Periprosthetic fractures of the femur after total knee arthroplasty: a literature review and treatment algorithm. Clin Orthop Relat Res. 1991;271:135–42.Google Scholar
  2. 2.
    Walsh G, Ankarath S, Giannoudis PV. Periprosthetic fractures above a total knee arthroplasty—a review of best practice. Curr Orthop. 2006;20(5):376–85.CrossRefGoogle Scholar
  3. 3.
    Saidi K, Ben-Lulu O, Tsuji M, Safir O, Gross AE, Backstein D. Supracondylar periprosthetic fractures of the knee in the elderly patients: a comparison of treatment using allograft-implant composites, standard revision components, distal femoral replacement prosthesis. J Arthroplast. 2014;29(1):110–4.CrossRefGoogle Scholar
  4. 4.
    Rorabeck CH, Taylor JW. Periprosthetic fractures of the femur complicating total knee arthroplasty. Orthop Clin N Am. 1999;30(2):265–77.CrossRefGoogle Scholar
  5. 5.
    Parvizi J, Jain N, Schmidt AH. Periprosthetic knee fractures. J Orthop Trauma. 2008;22(9):663–71.CrossRefGoogle Scholar
  6. 6.
    Mortazavi SJ, Kurd MF, Bender B, Post Z, Parvizi J, Purtill JJ. Distal femoral arthroplasty for the treatment of periprosthetic fractures after total knee arthroplasty. J Arthroplast. 2010;25(5):775–80.CrossRefGoogle Scholar
  7. 7.
    McGraw P, Kumar A. Periprosthetic fractures of the femur after total knee arthroplasty. J Orthop Traumatol. 2010;11(3):135–41.CrossRefGoogle Scholar
  8. 8.
    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(9):1094–102.CrossRefGoogle Scholar
  9. 9.
    Kassab M, Zalzal P, Azores GM, Pressman A, Liberman B, Gross AE. Management of periprosthetic femoral fractures after total knee arthroplasty using a distal femoral allograft. J Arthroplast. 2004;19(3):361–8.CrossRefGoogle Scholar
  10. 10.
    Johnston AT, Tsiridis E, Eyres KS, Toms AD. Periprosthetic fractures in the distal femur following total knee replacement: a review and guide to management. Knee. 2012;19(3):156–62.CrossRefGoogle Scholar
  11. 11.
    Chen AF, Choi LE, Colman MW, Goodman MA, Crossett LS, Tarkin IS, McGough RL. Primary versus secondary distal femoral arthroplasty for treatment of total knee arthroplasty periprosthetic femur fractures. J Arthroplast. 2013;28(9):1580–4.CrossRefGoogle Scholar
  12. 12.
    Haidukewych GJ, Jacofsky DJ, Hanssen AD. Treatment of periprosthetic fractures around a total knee arthroplasty. J Knee Surg. 2003;16(2):111–7.PubMedGoogle Scholar
  13. 13.
    Bezwada HP, Neubauer P, Baker J, Israelite CL, Johanson NA. Periprosthetic supracondylar femur fractures following total knee arthroplasty. J Arthroplast. 2004;19(4):453–8.CrossRefGoogle Scholar
  14. 14.
    Rao B, Kamal T, Vafe J, Moss M. Distal femoral replacement for selective periprosthetic fractures above a total knee arthroplasty. Eur J Trauma Emerg Surg. 2014;40(2):191–9.CrossRefGoogle Scholar
  15. 15.
    Inglis AE, Walker PS. Revision of failed knee replacements using fixed-axis hinges. J Bone Joint Surg Br. 1991;73(5):757–61.CrossRefGoogle Scholar
  16. 16.
    Kumar A, Chambers I, Maistrelli G, Wong P. Management of periprosthetic fracture above total knee arthroplasty using intramedullary fibular allograft and plate fixation. J Arthroplast. 2008;23(4):554–8.CrossRefGoogle Scholar
  17. 17.
    Lotke PA, Lonner JH. Knee arthroplasty. 2nd ed. Philadelphia: Lippincott Williams and Wilkins; 2003.Google Scholar
  18. 18.
    Rorabeck CH, Taylor JW. Classification of periprosthetic fractures complicating total knee arthroplasty. Orthop Clin N Am. 1999;30(2):209–14.CrossRefGoogle Scholar
  19. 19.
    Greidanus NV, Masri BA, Garbuz DS, Wilson SD, McAlinden MG, Xu M, Duncan CP. Use of erythrocyte sedimentation rate and C-reactive protein level to diagnose infection before revision total knee arthroplasty. J Bone Joint Surg Am. 2007;89(7):1409–16.PubMedGoogle Scholar
  20. 20.
    Cordeiro EN, Costa RC, Carazzato JG, Silva JD. Periprosthetic fractures in patients with total knee arthroplasties. Clin Orthop Relat Res. 1990;252:182–9.Google Scholar
  21. 21.
    Chen F, Mont MA, Bachner RS. Management of ipsilateral supracondylar femur fractures following total knee arthroplasty. J Arthroplast. 1994;9(5):521–6.CrossRefGoogle Scholar
  22. 22.
    Su ET, DeWal H, Di Cesare PE. Periprosthetic femoral fractures above total knee replacements. J Am Acad Orthop Surg. 2004;12(1):12–20.CrossRefGoogle Scholar
  23. 23.
    Calori GM, Colombo M, Malagoli E, Mazzola S, Bucci M, Mazza E. Megaprosthesis in post-traumatic and periprosthetic large bone defects: issues to consider. Injury. 2014;45:S105–10.CrossRefGoogle Scholar
  24. 24.
    Harrison RJ Jr, Thacker MM, Pitcher JD, Temple HT, Scully SP. Distal femur replacement is useful in complex total knee arthroplasty revisions. Clin Orthop Relat Res. 2006;446:113–20.CrossRefGoogle Scholar
  25. 25.
    Haidukewych GJ, Springer BD, Jacofsky DJ, Berry DJ. Total knee arthroplasty for salvage of failed internal fixation or nonunion of the distal femur. J Arthroplast. 2005;20(3):344–9.CrossRefGoogle Scholar
  26. 26.
    Backstein D, Safir O, Gross A. Management of bone loss: structural grafts in revision total knee arthroplasty. Clin Orthop Relat Res. 2006;446:104–12.CrossRefGoogle Scholar
  27. 27.
    Bauman RD, Lewallen DG, Hanssen AD. Limitations of structural allograft in revision total knee arthroplasty. Clin Orthop Relat Res. 2009;467(3):818–24.CrossRefGoogle Scholar
  28. 28.
    Wong P, Gross AE. The use of structural allografts for treating periprosthetic fractures about the hip and knee. Orthop Clin N Am. 1999;30(2):259–64.CrossRefGoogle Scholar
  29. 29.
    Virolainen P, Mokka J, Seppänen M, Mäkelä K. Up to 10 years follow up of the use of 71 cortical allografts (strut-grafts) for the treatment of periprosthetic fractures. Scand J Surg. 2010;99(4):240–3.CrossRefGoogle Scholar
  30. 30.
    Kappe T, Cakir B, Mattes T, Reichel H, Flören M. Infections after bone allograft surgery: a prospective study by a hospital bone bank using frozen femoral heads from living donors. Cell Tissue Bank. 2010;11(3):253–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Michael Suk
    • 1
  • Michael R. Rutter
    • 2
  1. 1.Musculoskeletal Institute, Geisinger Health SystemDanvilleUSA
  2. 2.Department of Orthopedic SurgeryGeisinger Medical CenterDanvilleUSA

Personalised recommendations