Locked compression plate for the treatment of periprosthetic femoral fractures above a total knee arthroplasty

Abstract

Background The incidence of periprosthetic femoral fractures above a total knee arthroplasty (TKA) is continuously increasing because of an increasing number of knee joint replacements and an enhanced survivorship of the elderly population after knee arthroplasty. Locked compression plate (LCP) devices designed for the distal femur offer advantages for the treatment of such fractures. LCPs can be inserted with relative ease, provide a fixed-angle construct and improve the fixation in osteoporotic bones. Patients and methods During the period between January 2008 and March 2011, 12 displaced distal femoral periprosthetic fractures above a well-fixed nonstemmed TKA in 12 patients were treated by a lateral LCP. The mean age of the patients at the time of surgery was 62 years (range 58-68 years), comprising 10 women and two men. One patient did not complete the follow-up and was excluded from the analysis. Hence, 11 fractures were available for a minimum follow-up of 6 months or until fracture healing. Results Radiographical union was obtained in 10 (91%) out of 11 patients. Nonunion occurred in one (9%) case. The mean consolidation time was 14 weeks (range 12-16 weeks). No axial deviation over 10° was noted. There were no mechanical complications due to failure of the implant. No general, decubitus, or infectious complications were noted. Functional recovery was satisfactory. Conclusion Osteosynthesis with LCP is effective in the treatment of periprosthetic, distal femoral fractures above a TKA without component loosening. It is beneficial for the management of these challenging fractures with a high rate of fracture healing.