Abstract
ObjectiveAs periprosthetic knee fractures are becoming common with the increase in incidence of primary and revision total knee arthroplasty, their management and treatment have become important. The current study aims to evaluate the revision knee arthroplasty carried out due to the failure of primary treatment of periprosthetic femoral fractures. MethodsThe study was conducted from May 2012 to September 2019 at Orthopedics department of Xinjiang Medical University; out of 21 patients 11 were women and 10 men aged 44 to 80 (mean, 70.76 ± 8.31) years who underwent revision surgery for periprosthetic fractures of 19 distal femur, 1 patellar, and 1 proximal tibial fracture. Nineteen cases had definite trauma history leading to periprosthetic fracture, and 2 cases had fracture during post-operative functional exercise. All patients had revision surgery with extended stems with either constrained or limited condylar knee prosthesis. ResultsThe duration of follow-up averaged 4.3 years. The Hospital for Special Surgery (HSS) knee score before fracture averaged 91 + 7.01 points (89–95 points) and 85.5 + 6.18 points (81–90 points) at the last follow-up. The average range of motion of knee joint before fracture was 115.7 [+7.6] (110 [~126]), and 101.3 [+9.8] (85 [~115]) at the last follow-up. There was no significant statistical difference. No complications such as infection, component loosening or nonunion. 2 patients had lower extremity vein thrombosis. ConclusionRevision surgery of the knee for the periprosthetic fractures with proper prosthetic selection can attain good outcomes after primary total knee arthroplasty. Reasonable and correct procedure is the main principle for a successful operation. The benefits and applicability of revision TKA is the reconstructive solution for the issues of prosthetic knee fractures, is highly recommended.
Highlights
Total knee arthroplasty is a well-known reconstructive technique
As periprosthetic knee fractures are becoming common with the increase in prevalence of primary and revision total knee arthroplasty, their management and treatment have become important.[3]
The present study aims to assess the revision surgery carried out due to periprosthetic fractures after primary total knee arthroplasty
Summary
Total knee arthroplasty is a well-known reconstructive technique. In only USA, 700,000 such procedures are carried out each year. In the last few years, the rate of primary TKA has doubled in many countries.[1] the periprosthetic fractures around the knee have increased tremendously over these years. As periprosthetic knee fractures are becoming common with the increase in prevalence of primary and revision total knee arthroplasty, their management and treatment have become important.[3] The treatment of periprosthetic fractures is oriented to re-establish alignment and gain pain functional range of motion devoid of pain. Many strategies have been recommended to manage periprosthetic fractures in order to gain a stable, functional, and well aligned knee.[4] The treatment of periprosthetic fractures is directed toward osteosynthesis through fixed plate fixation or retrograde nailing and revision with extended rod prosthesis.[5] many non-modifiable risk factors have been found to complex the surgical treatment of periprosthetic fractures
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