The Outcome and Complications of the Locked Plating Management for the Periprosthetic Distal Femur Fractures after a Total Knee Arthroplasty.
10.4055/cios.2013.5.2.124
- Author:
Ashok S GAVASKAR
1
;
Naveen Chowdary TUMMALA
;
Muthukumar SUBRAMANIAN
Author Information
1. Department of the Adult Joint Reconstructive Surgery, Parvathy Hospital, Chennai, India. gavaskar.ortho@gmail.com
- Publication Type:Original Article
- Keywords:
Total knee arthroplasty;
Periprosthetic fractures;
Locked plating;
Distal femur fractures;
Osteosynthesis
- MeSH:
Aged;
Aged, 80 and over;
Arthroplasty, Replacement, Knee/*adverse effects;
Female;
Femoral Fractures/*etiology/radiography;
Fracture Fixation, Internal/*adverse effects;
Humans;
Male;
Osteoporosis/epidemiology;
Periprosthetic Fractures/*etiology/radiography;
Postoperative Complications/etiology;
Range of Motion, Articular;
Retrospective Studies;
Risk Factors;
Treatment Outcome
- From:Clinics in Orthopedic Surgery
2013;5(2):124-128
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The osteosynthesis of the periprosthetic fractures following a total knee arthroplasty (TKA) can be technically difficult with the relatively small satisfactory outcomes and the high complication rates. The purpose of the study is to analyze the mid-term radiological and functional outcomes following the locked plating of the distal femur periprosthetic fractures after a TKA. METHODS: Records of 20 patients with a periprosthetic distal femur fracture following TKA treated by the locked plate osteosynthesis were retrospectively evaluated. The union rate, complications and functional outcome measures were analyzed. RESULTS: Successful union was achieved in 18 of the 19 patients available for the follow-up. The mean follow-up was 39 +/- 10 months. Significant reductions (p < 0.05) in the range of motion and Western Ontario and McMaster Universities Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were evident in the follow-up. Secondary procedures were required in 5 patients to address the delay in union and the reduced knee range of motion. The osteosynthesis failed in 1 patient who underwent a revision TKA. CONCLUSIONS: The satisfactory union rates can be achieved with the locked plate osteosynthesis in the periprosthetic distal femur fractures after TKA. Prolonged rehabilitation coupled with the un-modifiable risk factors can decrease the activity and satisfaction levels, which can significantly alter the functional outcome.