Antegrade endosteal fibular strut augmentation for periprosthetic femoral fracture above stemmed total knee arthroplasty

Abstract

Total knee arthroplasty is one of the most common procedures performed in orthopaedics. As the population prevalence of total knee replacements increases, so does the incidence of revision procedures and periprosthetic fractures. A fracture adjacent to a stemmed femoral component poses a challenge to the treating surgeon. Bone quality, bone loss, and limits imposed by the femoral stem restrict the number of fixation options. The goal of surgical intervention is to allow early range of motion and weight bearing in this often elderly population. This article presents a surgical technique using an antegrade endosteal fibular strut to augment lateral locking plate fixation. The technique was used in an elderly patient who sustained a pathologic fracture with medial cortex loss above a femoral stem prosthesis.