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Review paper

Standard plating vs. cortical strut and plating for periprosthetic knee fractures: a multicentre experience

By
Giuseppe Rollo ,
Giuseppe Rollo

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

Enrico Maria Bonura Orcid logo ,
Enrico Maria Bonura
Contact Enrico Maria Bonura

Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy

Gazi Huri ,
Gazi Huri

Orthopaedics and Traumatology Department, Hacettepe University School of Medicine, Ankara, Turkey

Mario Ronga ,
Mario Ronga

Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy

Christian Carulli ,
Christian Carulli

Orthopaedic Clinic, University of Florence, Florence, Italy

Michele Bisaccia ,
Michele Bisaccia

Orthopaedics and Traumatology Unit, Department of Surgical and Biomedical Science, S.M. Misericordia Hospital, University of Perugia, Perugia, Italy

Francesco Traina ,
Francesco Traina

Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy

Paolo Pichierri ,
Paolo Pichierri

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

Marco Filipponi ,
Marco Filipponi

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

Marco Giaracuni ,
Marco Giaracuni

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

Danilo Leonetti ,
Danilo Leonetti

Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy

Luigi Meccariello
Luigi Meccariello

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy

Abstract

Aim
Periprosthetic fracture after knee arthroplasty occurs more frequently in the supracondylar area of femur, especially after low energy trauma associated with torsional or compressive forces. Several techniques have been described for the treatment of displaced fractures. The aim of this study is the evaluation of the outcomes and bone healing of periprosthetic femoral fractures managed by standard plate fixation compared to plating with bone grafting.
Methods
Thirty-six periprosthetic fractures around the knee were selected. Eighteen patients underwent standard plate and screws fixation while other eighteen were treated by plating associate with a cortical strut. Knee Society Score (KSS) and Short Form 12 (SF12) with the UNION SCORE (RUS) were used for the evaluation of results.
Results
After a minimum follow-up of 12 months, the results showed a statistically significant difference in SF-12, KSS, and RUS in favour of plating associated to bone graft with respect to the plating alone; four cases of non-union were recorded in the group of patients treated by standard plating.
Conclusions
Our experience once again demonstrated that plating and bone grafting may ensure a mechanical and biological support for the healing of periprosthetic fracture of the knee more than simple plating.

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