Distal sleeve/metal tantalum cone for low-position periprosthetic fractures of the distal femur (types Su Ⅱ and Ⅲ) after total knee arthroplasty: short-term efficacy
10.3760/cma.j.cn115530-20250209-00055
- VernacularTitle:金属袖套或金属钽锥治疗全膝关节置换术后Su Ⅱ、Ⅲ型股骨低位假体周围骨折的近期疗效分析
- Author:
Xu LIU
1
;
Wenbo MU
1
;
Li CAO
1
Author Information
1. 新疆医科大学第一附属医院关节外科，新疆地区高发疾病研究教育部重点实验室（新疆医科大学），新疆骨科疾病临床医学研究中心，乌鲁木齐 830011
- Publication Type:Journal Article
- Keywords:
Arthroplasty, replacement, knee;
Femoral fractures;
Fracture fixation, internal;
Sleeve;
Cone;
Periprosthetic fractures
- From:
Chinese Journal of Orthopaedic Trauma
2025;27(6):485-491
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the short-term efficacy of metaphyseal sleeves or metal tantalum cones in the treatment of low-position periprosthetic fractures of the distal femur (types Su Ⅱ and Ⅲ) after total knee arthroplasty (TKA).Methods:A retrospective study was conducted to analyze the data of the 14 patients who had been treated at Department of Joint surgery, The First Hospital Affiliated to Xinjiang Medical University for low-position periprosthetic fractures of the distal femur (types Su Ⅱ and Ⅲ) after TKA from January 2021 to December 2023. The cohort included 8 males and 6 females with an age of (73.3±4.0) years. The median time from the TKA to the low-position periprosthetic fracture was 37.5 (15.0, 62.3) months. The patients were treated with either a metaphyseal sleeve (8 cases) or a tantalum metal cone (6 cases). The following parameters were recorded for each patient: operative time, complications during follow-up, and assessments at the final follow-up including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS) for pain, American Knee Society Score (KSS), maximum extension angle, and maximum flexion angle.Results:The operative time for this group was 93 (87, 101) min. The 14 patients were followed up for 10.0 (8.0, 12.0) months postoperatively. At the final follow-up, the WOMAC score [(11.01±2.67) points] and VAS pain score [1.00 (0.75, 1.05) points] for the 14 patients were significantly lower than their preoperative values [(44.49±2.64) points and 7.55 (7.00, 8.00) points], while their KSS functional score and joint score [(64.93±2.69) points and (86.73±4.61) points] were significantly higher than their preoperative values [(15.20±2.27) points and (19.59±3.33) points] ( P<0.05). Their maximum flexion angle (91.92°±2.55°) was significantly greater than the preoperative one (67.60°±7.76°) ( P<0.05). However, there was no statistically significant difference in the maximum extension angle between preoperation and postoperation ( P>0.05). Postoperatively, 2 patients developed intermuscular vein thrombosis and 3 deep venous thrombosis, but standardized thromboprophylaxis and treatment led to complete resolution of the thrombi with no adverse events. No patients experienced such complications as infection, fixation loosening, or non-union at the fracture site. Conclusion:In the treatment of low-position periprosthetic fractures of the distal femur (types Su Ⅱ and Ⅲ) after TKA, the metaphyseal sleeve and tantalum cone techniques significantly improve knee joint function, alleviate pain severity, and enhance patients' quality of life, demonstrating satisfactory short-term efficacy.
