Fracturas periprotésicas de fémur en artroplastia total de rodilla: experiencia con técnica mínimamente invasiva

Abstract

BackgroundPeri-prosthetic fracture of the distal femur above total knee arthroplasty presents a challenging surgical problem for orthopaedic surgeons, as complication rates for both surgical and non-surgical treatment have been reported to be as high as 30%.The minimally invasive plate osteosynthesis (MIPO) technique seems to have better results than other techniques in this type of fracture when there is no loosening of the femoral implant. MethodsA total of 32 patients with this fracture were treated from January 2005 to December 2011. A retrospective review was conducted on the weeks of consolidation, range of motion, final alignment, and the ability to walk. The mean follow up was 56.5 months (25-144). ResultsA total of 32 (31 female, 1 male) patients, with a mean age 77 (70-89) years old were treated, of whom 3 (9%) died and 4 were lost to follow-up.The mean time of consolidation was 16.5 weeks (8-24). There were no infections, although there were 3 non-unions and 1 malalignment (15° of valgus). We were able to restore the range of motion in every patient as it was before the fracture, as well as the ability to walk outdoors in 24 patients. ConclusionThe MIPO technique is a great technique in order to achieve a good range of motion and alignment of these fractures.Level of evidence IV.