Fractures of the distal femur, proximal tibia, and patella that occur adjacent to a total knee replacement may be very difficult to treat. Fixation options are compromised because of the short articular segment, frequent comminution, pre-existing osteoporosis, previous surgical incisions, and the presence of the knee implant itself.
Vancouver B1 periprosthetic fractures are best described as those fractures distal to the intertrochanteric region of the femur but around the femoral stem. By definition, the femoral stem is considered well fixed in B1 (Fig. 3) fractures. The morphology of the fracture dictates the type of fixation.
Periprosthetic fracture occurring in relation to total knee arthroplasty presents significant challenges to the orthopedic surgeon. Clear guidelines do not yet exist as to the best way to manage many of these fractures. An important aspect of the development of understanding of these problems is the classification of these fractures.
Supracondylar femoral fractures Supracondylar periprosthetic fractures are those within 15cm of the knee joint line or within 5cm of the proximal end of the implant2,4,20 (Figs. 1 and 2). They account for the majority of periprosthetic fractures around the knee.1,3,9,21,22 Their overall incidence ranges from 0.3% to.
Periprosthetic fractures of the tibia and patella are also described, but are less common. This review article provides an overview of the epidemiology and frequency of periprosthetic fractures around total knee replacement, their initial assessment and the current treatment options available.Learn More
Periprosthetic femoral fractures are largely classified by the Vancouver classification for periprosthetic fractures of the hip as well as the Rorabeck classification for periprosthetic femur fractures knee. However, the established classification does not cover the whole spectrum of periprosthetic femoral fractures.Learn More
Pathologic fractures don’t always have symptoms. When they do, they share the same symptoms as an injury-related fracture. These include: mild to severe pain near the broken bone.Learn More
A comprehensive classification systems for periprosthetic distal femur fractures is the Lewis and Rorabeck Classification. Periprosthetic femoral fractures following a TKA which are usually treated with ORIF are Rorabeck Type I and Type II displaced fractures where the knee prosthesis is intact.(1) (1) Rorabeck CH, Taylor JW.Learn More
Periprosthetic fractures after knee arthroplasty 29 periprosthetic fractures. Our study aimed to compare pre-operative mechanical factors (including coronal leg alignment and pre-operative range of motion) between patients sustaining periprosthetic fractures after TKR against a gender and age-matched control group with no periprosthetic fracture.Learn More
Supracondylar fractures of the femur are the most common type and this review will focus on the incidence, risk factors, classification, investigation, and treatment options for periprosthetic.Learn More
Chronic, atrophic nonunion of a periprosthetic distal femur fracture proximal to a well-fixed total knee replacement. The patient had two prior attempts at open reduction internal fixation with.Learn More
Periprosthetic fractures are being encountered with increasing frequency as the number of primary total knee arthroplasties being performed increases. Management of these fractures presents a significant challenge to the orthopedic surgeon largely because most surgeons do not have a large clinical experience with this problem.Learn More
Material and methods: Between 2005 and 2008, a total of 13 supracondylar periprosthetic knee fractures were treated by the LCP technique. The patient group included 10 women and three men the average age was 67.4 (range, 56-81) years. The fractures were classified using the system proposed by Su et al. and the AO classification system.Learn More
Supracondylar Fractures of the Femur 1. Causes and Risk Factors. Periprosthetic fracture following TKA occurs most frequently in the femur, primarily in the supracondylar area 1, 2) ().Femoral supracondylar fractures are observed in 0.3%-2.5% of TKA patients mostly within 2 to 4 years after surgery 5, 6, 7).They are commonly noted in the knee with a well-fixed femoral component mostly after.Learn More
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.Learn More
Fracture terminology and the Vancouver classification system are reviewed in a simplified algorithm with emphasis on the most common patterns of periprosthetic fractures, the radiologic determinants of prosthesis stability and bone quality, and the management implications of these imaging findings.Learn More