Abstract
BackgroundPeriprosthetic fractures of the distal femur above a total knee arthroplasty (TKA) have traditionally been managed by locking compression plating (LCP). This technique is technically demanding and is associated with high rates of non-union and revision. More recently, retrograde intramedullary nailing (RIMN) has been proposed as an acceptable alternative. This meta-analysis aims to evaluate clinical outcomes in patients with periprosthetic supracondylar femoral fractures who were treated with LCP and RIMN.MethodsAn up-to-date literature search was carried out using the pre-defined search strategy. All studies that met the inclusion criteria were assessed for methodological quality with the Cochrane’s collaboration tool. Operative time, functional score, time-to-union, non-union rates and revision rates were all considered.ConclusionTen studies with a total of 531 periprosthetic fractures were included. This meta-analysis has suggested that there is no significant difference in any of the outcome measures assessed. Further, more extensive literature is required on the subject to draw more robust conclusions.
Highlights
Periprosthetic fractures of the distal femur above a total knee arthroplasty (TKA) have traditionally been managed by locking compression plating (LCP)
The aim of this study is to examine the clinical outcomes for LCP and retrograde intramedullary nailing (RIMN) in the treatment of periprosthetic femur fractures around a total knee replacement (TKR) and provide the most up-to
Literature search results The initial search of the Medline and Embase databases resulted in 1986 articles, and 2 other articles were added to literature search from other sources
Summary
Periprosthetic fractures of the distal femur above a total knee arthroplasty (TKA) have traditionally been managed by locking compression plating (LCP). This technique is technically demanding and is associated with high rates of non-union and revision. Retrograde intramedullary nailing (RIMN) has been proposed as an acceptable alternative This meta-analysis aims to evaluate clinical outcomes in patients with periprosthetic supracondylar femoral fractures who were treated with LCP and RIMN. The incidence is expected to increase further due to growing population longevity and provision of service [2, 4, 6]. The treatment of these fractures remains a challenge for orthopaedic surgeons. The ideal treatment modality remains controversial where a consensus is not clear in the literature [7, 12–20]
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