Distal Femoral Replacement for Periprosthetic Fractures around Total Knee Arthroplasty: When and How?

Abstract

Periprosthetic fractures around total knee arthroplasty have become more common with the increasing incidence of total knee arthroplasty. These fractures are challenging to treat, especially in older patients with poor bone stock. Although open reduction internal fixation remains the most common treatment, revision with distal femoral replacement has become popular in recent years. Careful evaluation and planning are required to have successful outcomes. We present a review of distal femoral replacement in periprosthetic fractures around the total knee arthroplasty, along with surgical technique, and pearls and pitfalls.

Keywords

distal femur periprosthetic fracture - revision total knee arthroplasty - distal femoral replacement

• References

• 1 HCPUnet, Healthcare Cost and Utilization Project. Agency for Healthcare Research and Quality. . Available at: http://hcupnet.ahrq.gov . Accessed December 20, 2018
• 2 Alden KJ, Duncan WH, Trousdale RT, Pagnano MW, Haidukewych GJ. Intraoperative fracture during primary total knee arthroplasty. Clin Orthop Relat Res 2010; 468 (01) 90-95
• 3 Singh JA, Jensen M, Lewallen D. Predictors of periprosthetic fracture after total knee replacement: an analysis of 21,723 cases. Acta Orthop 2013; 84 (02) 170-177
• 4 Meek RM, Norwood T, Smith R, Brenkel IJ, Howie CR. The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement. J Bone Joint Surg Br 2011; 93 (01) 96-101
• 5 Su ET, DeWal H, Di Cesare PE. Periprosthetic femoral fractures above total knee replacements. J Am Acad Orthop Surg 2004; 12 (01) 12-20
• 6 Rorabeck CH, Taylor JW. Classification of periprosthetic fractures complicating total knee arthroplasty. Orthop Clin North Am 1999; 30 (02) 209-214
• 7 Kuzyk PRT, Watts E, Backstein D. Revision total knee arthroplasty for the management of periprosthetic fractures. J Am Acad Orthop Surg 2017; 25 (09) 624-633
• 8 Rao B, Kamal T, Vafe J, Moss M. Distal femoral replacement for selective periprosthetic fractures above a total knee arthroplasty. Eur J Trauma Emerg Surg 2014; 40 (02) 191-199
• 9 Jassim SS, McNamara I, Hopgood P. Distal femoral replacement in periprosthetic fracture around total knee arthroplasty. Injury 2014; 45 (03) 550-553
• 10 Barrack RL. Evolution of the rotating hinge for complex total knee arthroplasty. Clin Orthop Relat Res 2001; (392) 292-299
• 11 Berend KR, Lombardi Jr AV. Distal femoral replacement in nontumor cases with severe bone loss and instability. Clin Orthop Relat Res 2009; 467 (02) 485-492
• 12 Kim KI, Egol KA, Hozack WJ, Parvizi J. Periprosthetic fractures after total knee arthroplasties. Clin Orthop Relat Res 2006; 446 (446) 167-175
• 13 Saidi K, Ben-Lulu O, Tsuji M, Safir O, Gross AE, Backstein D. Supracondylar periprosthetic fractures of the knee in the elderly patients: a comparison of treatment using allograft-implant composites, standard revision components, distal femoral replacement prosthesis. J Arthroplasty 2014; 29 (01) 110-114
• 14 Petrou G, Petrou H, Tilkeridis C. , et al. Medium-term results with a primary cemented rotating-hinge total knee replacement. A 7- to 15-year follow-up. J Bone Joint Surg Br 2004; 86 (06) 813-817
• 15 Girgis E, McAllen C, Keenan J. Revision knee arthroplasty using a distal femoral replacement prosthesis for periprosthetic fractures in elderly patients. Eur J Orthop Surg Traumatol 2018; 28 (01) 95-102
• 16 Hoellwarth JS, Fourman MS, Crossett L. , et al. Equivalent mortality and complication rates following periprosthetic distal femur fractures managed with either lateral locked plating or a distal femoral replacement. Injury 2018; 49 (02) 392-397
• 17 Mortazavi SM, Kurd MF, Bender B, Post Z, Parvizi J, Purtill JJ. Distal femoral arthroplasty for the treatment of periprosthetic fractures after total knee arthroplasty. J Arthroplasty 2010; 25 (05) 775-780