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.
Agarwal S, Sharma R, Jain J. Periprosthetic fractures after total kneearthroplasty. J Orthop Surg. 2014;24–9.
2.
Ebraheim N, Kelley L, Liu X, Thomas I, Steiner R, Liu J. Periprosthetic distal femur fracture after total knee arthroplasty: a systematic review. Orthop Surg. 2015;297–305.
3.
Mcgraw P, Kumar A. Periprosthetic fractures of the femur after total knee arthroplasty. Orthop Traumatol. 2010;135–41.
4.
Mukundan C, Rayan F, Kheir E, Macdonald D. Management of late periprosthetic femur fractures: a retrospective cohort of 72 patients. Int Orthop. 2010;485–9.
5.
Lindahl H, Oden A, Garellick G, Malchau H. The excess mortality due to periprosthetic femur fracture. A study from the Swedish national hip arthroplasty register. Bone. 2007;1294–8.
6.
Whitehouse M, Mehendale S. Periprosthetic fractures around the knee: current concepts and advances in management. Curr Rev Musculoskelet Med. 2014;136–44.
7.
Prins J, Donders J, Helfet D, Wellman D, Klinger C, Redko M, et al. Periprosthetic femoral nonunions treated with internal fixation and bone grafting. Injury. 2018;2295–301.
8.
Rorabeck C, Taylor J. Periprosthetic fractures of the femur complicating total knee arthroplasty. Orthop Clin North Am. 199AD;265–77.
9.
Lee D, Lee S, Song E, Seon J, Lim H, Yang H. Causes and clinical outcomes of revision total knee arthroplasty. Knee Surg Relat Res. 2017;104–9.
10.
Lizaur-Utrilla A, Miralles-Muñoz F, Sanz-Reig J. Functional outcome of total knee arthroplasty after periprosthetic distal femoral fracture. J Arthroplasty. 2013;1585–8.
11.
Calori G, Colombo M, Mazza E, Mazzola S, Malagoli E, Marelli N, et al. Validation of the Non-Union Scoring System in 300 long bone non-unions. Injury. 2014;(Suppl 6):93–7.
12.
Eschbach D, Buecking B, Kivioja H, Fischer M, Wiesmann T, Zettl R, et al. One year after proximal or distal periprosthetic fracture of the femur -two conditions with divergent outcomes. Injury. 2018;1176–82.
13.
Platzer P, Schuster R, Aldrian S, Prosquill S, Krumboeck A, Zehetgruber I, et al. Management and outcome of periprosthetic fractures after total knee arthroplasty. J Trauma. 2010;1464–70.
14.
Donnelly K, Tucker A, Ruiz A, Thompson N. Managing extremely distal periprosthetic femoral supracondylar fractures of total knee replacements -a new PHILOS-ophy. World J Orthop. 2017;809–13.
15.
Healy W, Siliski J, Incavo S. Operative treatment of distal femoral fractures proximal to total knee replacements. J Bone Joint Surg Am. 1993;27–34.
16.
Moran M, Brick G, Sledge C, Dysart S, Chien E. Supracondylar femoral fracture following total knee arthroplasty. Clin Orthop. 1996;196–209.
17.
Wang J, Wang C. Supracondylar fractures of the femur above total knee arthroplasties with cortical allograft struts. J Arthroplasty. 2002;365–72.
18.
Haddad F, Dehaan M, Brady O, Masri B, Garbuz D, Goertzen D, et al. A biomechanical evaluation of cortical onlay allograft struts in the treatment of periprosthetic femoral fracture. Hip International. 2003;148–58.
19.
Carta S, Fortina M, Riva A, Meccariello L, Manzi E, Giovanni D, et al. The biological metallic versus metallic solution in treating periprosthetic femoral fractures: outcome assessment. Adv Med. 2016;2918735.
20.
Peters C, Bachus K, Davitt J. Fixation of periprosthetic femur fractures: a biomechanical analysis comparing cortical strut allograft plates and conventional metal plates. Orthopedics. 2003;695–9.
21.
Rollo G, Tartaglia N, Falzarano G, Pichierri P, Stasi A, Medici A, et al. The challenge of non-union in subtrochanteric fractures with breakage of intramedullary nail: evaluation of outcomes in surgery revision with angled blade plate and allograft bone strut. Eur J Trauma Emerg Surg. 2017;853–61.
22.
Chandler H, King D, Limbird R, Hedley A, Mccarthy J, Penenberg B, et al. The use of cortical allograft struts for fixation of fractures associated with well-fixed total joint prostheses. Semin Arthroplasty. 1993;99–107.
23.
Emerson R, Malinin T, Cuellar A, Head W, Peters P. Cortical strut allografts in the reconstruction of the femur in revision total hip arthroplasty. A basic science and clinical study. Clin Orthop Relat Res. 1992;35–44.
24.
Brady O, Garbuz D, Masri B, Duncan C. The treatment of periprosthetic fractures of the femur using cortical onlay allograft struts. Orthop Clin North Am. 1999;249–57.
25.
Wilson D, Frei H, Masri B, Oxland T, Duncan C. A biomechanical study comparing cortical onlay allograft struts and plates in the treatment of periprosthetic femoral fractures. Clin Biomech. 2005;70–6.
26.
Chen S, Tai C, Yu T, Wang C, Lin C, Chen C, et al. Modified fixations for distal femur fractures following total knee arthroplasty: a biomechanical and clinical relevance study. Knee Surg Sports Traumatol Arthrosc. 2016;3262–71.
27.
Rollo G, Pichierri P, Marsilio A, Filipponi M, Bisaccia M, Meccariello L. The challenge of nonunion after osteosynthesis of the clavicle: is it a biomechanical or infection problem? Clin Cases Miner Bone Metab. 2017;372–8.
28.
Rollo G, Rotini R, Pichierri P, Giaracuni M, Stasi A, Macchiarola L, et al. Grafting and fixation of proximal humeral aseptic non union: a prospective case series. Clin Cases Miner Bone Metab. 2017;298–304.
29.
Munakata S, Nagahiro Y, Katori D, Muroi N, Akagi H, Kanno N, et al. Clinical efficacy of bone reconstruction surgery with frozen cortical bone allografts for nonunion of radial and ulnar fractures in toy breed dogs. Vet Comp Orthop Traumatol. 2018;159–69.
30.
Junior G, De Lima E, Momesso V, Mello-Neto G, Érnica J, N, et al. Potential of autogenous or fresh-frozen allogeneic bone block grafts for bone remodelling: a histological, histometrical, and immunohistochemical analysis in rabbits. Br J Oral Maxillofac Surg. 2017;589–93.
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