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Management of Periprosthetic Femur Fracture

  • Alfred J. TriaEmail author
  • Jason M. Jennings
  • Raymond H. Kim
  • Aldo M. Riesgo
  • William L. GriffinEmail author
Chapter

Abstract

Periprosthetic femur fractures are the most common fracture that leads to total knee arthroplasties. The undisplaced fracture can be treated nonoperatively. If the fracture is displaced, the femoral component must be evaluated for stability. If the component has enough underlying bone attached to it, fixation with component preservation may be possible. If the femoral component is completely loose from any underlying bone, replacement is the only alternative. Internal fixation preserves the original implant but exposes the patient to a longer period of recovery and possible nonunion. Total replacement is much more invasive but may be more predictable.

Keywords

Fractures Internal fixation Intramedullary rods Plates Hinges 

References

  1. 1.
    McGraw P, Kumar A. Periprosthetic fractures of the femur after total knee arthroplasty. J Orthop Traumatol. 2010;11(3):135–41.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Hart GP, Kneisl JS, Springer BD, Patt JC, Karunakar MA. Open reduction vs distal femoral replacement arthroplasty for comminuted distal femur fractures in the patients 70 years and older. J Arthroplast. 2017;32(1):202–6.CrossRefGoogle Scholar
  3. 3.
    Ricci WM, Loftus T, Cos BJ. Locked plates combined with minimally invasive insertion technique for the treatment of periprosthetic supracondylar femur fractures above a total knee arthroplasty. J Orthop Trauma. 2006;20:190–6.CrossRefPubMedGoogle Scholar
  4. 4.
    SM M, 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
  5. 5.
    Konan S, Sandiford N, Unno F, Masri BS, Garbuz DS, Duncan CP. Periprosthetic fractures associated with total knee arthroplasty: an update. Bone Joint J. 2016;98-B(11):1489–96.CrossRefPubMedGoogle Scholar
  6. 6.
    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
  7. 7.
    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
  8. 8.
    Neer CS, Grantham SA, Shelton ML. Supracondylar fracture of the adult femur. A study of one hundred and ten cases. J Bone Joint Surg Am. 1967;49(4):591–613.CrossRefPubMedGoogle Scholar
  9. 9.
    Lewis P, Rorabeck C. Periprosthetic fractures. In: Engh GA, Rorabeck CH, editors. Revision total knee arthroplasty. Baltimore: Williams & Wilkins; 1997. p. 275–95.Google Scholar
  10. 10.
    Bong MR, Egol KA, Koval KJ, et 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 Arthroplast. 2002;17(7):876–81.CrossRefGoogle Scholar
  11. 11.
    Meneghini RM, Keyes BJ, Reddy KK, Maar DC. Modern retrograde intramedullary nails versus periarticular locked plates for supracondylar femur fractures after total knee arthroplasty. J Arthroplast. 2014;29(7):1478–81.CrossRefGoogle Scholar
  12. 12.
    Li B, Gao P, Qiu G, Li T. Locked plate versus retrograde intramedullary nail for periprosthetic femur fractures above total knee arthroplasty: a meta-analysis. Int Orthop. 2016;40(8):1689–95.  https://doi.org/10.1007/s00264-015-2962-9.CrossRefPubMedGoogle Scholar
  13. 13.
    Ristevski B, Nauth A, Williams DS, et al. Systematic review of the treatment of periprosthetic distal femur fractures. J Orthop Trauma. 2014;28(5):307–12.CrossRefPubMedGoogle Scholar
  14. 14.
    Mäkinen TJ, Dhotar HS, Fichman SG, et al. Periprosthetic supracondylar femoral fractures following knee arthroplasty: a biomechanical comparison of four methods of fixation. Int Orthop. 2015;39(9):1737–42.CrossRefPubMedGoogle Scholar
  15. 15.
    Bae DK, Song SJ, Yoon KH, Kim TY. Periprosthetic supracondylar femoral fractures above total knee arthroplasty: comparison of the locking and non-locking plating methods. Knee Surg Sports Traumatol Arthrosc. 2014;22(11):2690–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Streubel PN, Gardner MJ, Morshed S, Collinge CA, Gallagher B, Ricci WM. Are extreme distal periprosthetic supracondylar fractures of the femur too distal to fix using a lateral locked plate? J Bone Joint Surg Br. 2010;92(4):527–34.CrossRefPubMedGoogle Scholar
  17. 17.
    Hoffmann MF, Jones CB, Sietsema DL, Koenig SJ, Tornetta P. Outcome of periprosthetic distal femoral fractures following knee arthroplasty. Injury. 2012;43(7):1084–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Hou Z, Bowen TR, Irgit K, et al. Locked plating of periprosthetic femur fractures above total knee arthroplasty. J Orthop Trauma. 2012;26(7):427–32.CrossRefPubMedGoogle Scholar
  19. 19.
    Kolb W, Guhlmann H, Windisch C, Marx F, Koller H, Kolb K. Fixation of periprosthetic femur fractures above total knee arthroplasty with the less invasive stabilization system: a midterm follow-up study. J Trauma. 2010;69(3):670–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Kolb W, Guhlmann H, Windisch C, Marx F, Kolb K, Koller H. Fixation of distal femoral fractures with the less invasive stabilization system: a minimally invasive treatment with locked fixed-angle screws. J Trauma. 2008;65(6):1425–34.CrossRefPubMedGoogle Scholar
  21. 21.
    Ebraheim NA, Carroll T, Bonaventura B, Moral MZ, Jabaly YG, Liu J. Challenge of managing distal femur fractures with long-stemmed total knee implants. Orthop Surg. 2014;6(3):217–22.CrossRefPubMedGoogle Scholar
  22. 22.
    Park J, Lee JH. Comparison of retrograde nailing and minimally invasive plating for treatment of periprosthetic supracondylar femur fractures (OTA 33-a) above total knee arthroplasty. Arch Orthop Trauma Surg. 2016;136(3):331–8.CrossRefPubMedGoogle Scholar
  23. 23.
    Shin YS, Kim HJ, Lee DH. Similar outcomes of locking compression plating and retrograde intramedullary nailing for periprosthetic supracondylar femoral fractures following total knee arthroplasty: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2016:1–8.Google Scholar
  24. 24.
    Horneff JG, Scolaro JA, Jafari SM, Mirza A, Parvizi J, Mehta S. Intramedullary nailing versus locked plate for treating supracondylar periprosthetic femur fractures. Orthopedics. 2013;36(5):e561–6.CrossRefPubMedGoogle Scholar
  25. 25.
    braheim NA, Kelley LH, Liu X, Thomas IS, Steiner RB, Liu J. Periprosthetic distal femur fracture after total knee arthroplasty: a systematic review. Orthop Surg. 2015;7(4):297–305.CrossRefGoogle Scholar
  26. 26.
    Ricci WM, Streubel PN, Morshed S, Collinge CA, Nork SE, Gardner MJ. Risk factors for failure of locked plate fixation of distal femur fractures: an analysis of 335 cases. J Orthop Trauma. 2014;28(2):83–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Tosounidis TH, Giannoudis PV. What is new in distal femur periprosthetic fracture fixation? Injury. 2015;46(12):2293–6.CrossRefPubMedGoogle Scholar
  28. 28.
    Platzer P, Schuster R, Aldrian S, et al. Management and outcome of periprosthetic fractures after total knee arthroplasty. J Trauma. 2010;68(6):1464–70.CrossRefPubMedGoogle Scholar
  29. 29.
    Hoffmann MF, Jones CB, Sietsema DL, Tornetta P, Koenig SJ. Clinical outcomes of locked plating of distal femoral fractures in a retrospective cohort. J Orthop Surg Res. 2013;8:43.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Hart GP, Kneisl JS, Springer BD, Patt JC, Karunakar MA. Open reduction vs distal femoral replacement arthroplasty for comminuted distal femur fractures in the patients 70 years and older. J Arthroplast. 2016;32(1):202–6.CrossRefGoogle Scholar
  31. 31.
    Bobak P, Polyzois I, Graham S, Gamie Z, Tsiridis E. Nailed cementoplasty: a salvage technique for rorabeck type II periprosthetic fractures in octogenarians. J Arthroplast. 2010;25(6):939–44.CrossRefGoogle Scholar
  32. 32.
    Parvizi J, Jain N, Schmidt AH. Periprosthetic knee fractures. J Orthop Trauma. 2008;22(9):663–71.CrossRefPubMedGoogle Scholar
  33. 33.
    Rahman WA, Vial TA, Backstein DJ. Distal femoral arthroplasty for management of periprosthetic supracondylar fractures of the femur. J Arthroplast. 2016;31(3):676–9.CrossRefGoogle Scholar
  34. 34.
    Streubel PN, Ricci WM, Wong A, Gardner MJ. Mortality after distal femur fractures in elderly patients. Clin Orthop Relat Res. 2011;469(4):1188–96.CrossRefPubMedGoogle Scholar
  35. 35.
    Langenhan R, Trobisch P, Ricart P, Probst A. Aggressive surgical treatment of periprosthetic femur fractures can reduce mortality: comparison of open reduction and internal fixation versus a modular prosthesis nail. J Orthop Trauma. 2012;26(2):80–5.CrossRefPubMedGoogle Scholar
  36. 36.
    Drew JM, Griffin WL, Odum SM, Van Doren B, Weston BT, Stryker LS. Survivorship after periprosthetic femur fracture: factors affecting outcome. J Arthroplast. 2016;31(6):1283–8.CrossRefGoogle Scholar
  37. 37.
    Jassim SS, McNamara I, Hopgood P. Distal femoral replacement in periprosthetic fracture around total knee arthroplasty. Injury. 2014;45(3):550–3.CrossRefPubMedGoogle Scholar
  38. 38.
    Herrera DA, Kregor PJ, Cole PA, Levy BA, Jönsson A, Zlowodzki M. Treatment of acute distal femur fractures above a total knee arthroplasty: systematic review of 415 cases (1981-2006). Acta Orthop. 2008;79(1):22–7.CrossRefPubMedGoogle Scholar
  39. 39.
    Zwingmann J, Krieg M, Thielemann F, Südkamp N, Helwig P. Long-term function following periprosthetic fractures. Acta Chir Orthop Traumatol Cechoslov. 2016;83(6):381–7.Google Scholar
  40. 40.
    CC H, Chen SY, Chen CC, Chang YH, Ueng SW, Shih HN. Superior survivorship of cementless vs cemented diaphyseal fixed modular rotating-hinged knee megaprosthesis at 7 years’ follow-up. J Arthroplast. 2016;32(6):1940–5.Google Scholar
  41. 41.
    Agarwal S, Azam A, Morgan-Jones R. Metal metaphyseal sleeves in revision total knee replacement. Bone Joint J. 2013;95-B(12):1640–4.CrossRefPubMedGoogle Scholar
  42. 42.
    Kamath AF, Lewallen DG, Hanssen AD. Porous tantalum metaphyseal cones for severe tibial bone loss in revision knee arthroplasty: a five to nine-year follow-up. J Bone Joint Surg Am. 2015;97(3):216–23.CrossRefPubMedGoogle Scholar
  43. 43.
    Lachiewicz PF, Bolognesi MP, Henderson RA, Soileau ES, Vail TP. Can tantalum cones provide fixation in complex revision knee arthroplasty? Clin Orthop Relat Res. 2012;470(1):199–204.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Orthopedic Center of New JerseySomersetUSA
  2. 2.Colorado Joint ReplacementPorter Adventist HospitalDenverUSA
  3. 3.Department of Mechanical and Materials EngineeringUniversity of DenverDenverUSA
  4. 4.Department of Orthopedic SurgeryJoan C. Edwards School of Medicine at Marshall UniversityHuntingtonUSA
  5. 5.Adult ReconstructionOrthoCarolina Hip and Knee CenterCharlotteUSA

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