Periprosthetic Fractures following Total Knee Arthroplasty

Byung Hoon Lee; Jae Ang Sim

doi:10.12671/jkfs.2020.33.1.52

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Lee and Sim: Periprosthetic Fractures following Total Knee Arthroplasty

Review Article

Journal of the Korean Fracture Society 2020; 33(1): 52-61.

Published online: 23 January 2020

DOI: https://doi.org/10.12671/jkfs.2020.33.1.52

Periprosthetic Fractures following Total Knee Arthroplasty

Byung Hoon Lee, M.D., Ph.D.

, Jae Ang Sim, M.D., Ph.D.

Department of Orthopaedics Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.

Correspondence to: Jae Ang Sim, M.D., Ph.D. Department of Orthopaedics Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, 21 Namdong-daero 774beon-gil, Namdong-gu, Incheon 21565, Korea. Tel: +82-32-460-3384, Fax: +82-32-423-3384, sim_ja@gilhospital.com

Received 8 January 2020 Revised 9 January 2020 Accepted 9 January 2020

The Korean Fracture Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Recently, as the elderly population increases, the incidence of total knee arthroplasty has increased, with a concomitant increase in the frequency of periprosthetic fractures. To determine the treatment plan for fractures, the treatment method should be determined by the patient's age, osteoporosis, fixation status of the implant, and type of fracture. In recent years, operative treatment with reduction and stable fixation, rather than non-operative treatment, was used to promote early joint movement and gait. On the other hand, it is necessary to select an appropriate operative method to reduce complications of surgery, such as nonunion and infection, and expect a good prognosis. In this review, periprosthetic fractures were divided into femur, tibia, and patella fractures, and their causes, risk factors, classification, and treatment are discussed.

Keywords: Knee, Arthroplasty, Periprosthetic fractures

Figures and Tables

Fig. 1

Periprosthetic fracture with a comminuted fracture in the medial cortex of the distal femur was fixed with dual locking plates using the minimally invasive plate osteosynthesis (MIPO) technique. (A, B) Preoperative radiographs. (C, D) Postoperative radiographs. (E-G) Radiographs one year after surgery.

Fig. 2

Extruded nail (A) caused the wear of polyethylene post (B).

Fig. 3

Periprosthetic fracture of the proximal tibia was fixed with dual locking plates using the minimally invasive plate osteosynthesis (MIPO) technique. (A, B) Preoperative radiographs. (C, D) Postoperative radiographs. (E-G) Radiographs 1 year after surgery.

Fig. 4

Patellar fracture with non-operative treatment obtained bony union. (A) Radiograph at the time of injury. (B) Radiograph six months after injury.

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ORCID iDs

Byung Hoon Lee
https://orcid.org/0000-0002-1548-5691

Jae Ang Sim
https://orcid.org/0000-0002-2055-6458

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