Open reduction and polyaxial plating for stemmed knee periprosthetic fractures: A case series.

IF 1.8 Q2 ORTHOPEDICS SICOT-J Pub Date : 2023-01-01 DOI:10.1051/sicotj/2023022
Diego Gonzalez-Morgado, Jose Vicente Andres-Peiro, Jordi Selga Marsa, Carlos Alberto Piedra Calle, Josep Francesc Nomdedeu Sancho, Jordi Teixidor Serra, Jordi Tomas Hernandez
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Abstract

Introduction: Stemmed total knee arthroplasty (STKA) periprosthetic fractures (PPFs) are an emerging problem affecting frail patients. Their surgical fixation is challenging, due to intramedullary involvement and poor bone stock. Polyaxial locking plating has yielded good results in implant-related femur fractures. We hypothesized that this treatment would provide similar results for STKA PPFs.

Methods: Retrospective analysis of consecutive patients with a femoral PPF or inter-implant fracture around a knee revision stem who had undergone open reduction and periprosthetic-specific polyaxial plate fixation.

Results: We found 14 cases of mean age 85.4 years. Cerclages were used in 80% of cases. Fixation of a mean 8.6 cortices around the revision stem was achieved, with an overall screw density of 1:2 or 1:3. Four patients lost their ability to walk, while four experienced postoperative local complications. Bone healing was achieved in all except one who died during hospitalization. The 13 remaining survived the first year of follow-up.

Conclusion: STKA PPFs are an emerging and challenging problem affecting frail patients. Treatment using polyaxial locking plates provides stable fixation allowing early mobilization despite high complication rates.

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开放性复位和多轴钢板治疗膝关节假体周围骨折:一个病例系列。
导言:全膝关节置换术(STKA)假体周围骨折(PPFs)是一个影响体弱患者的新兴问题。由于髓内受累和不良的骨存量,其手术固定是具有挑战性的。多轴锁定钢板治疗与植入物相关的股骨骨折效果良好。我们假设这种治疗方法对STKA ppf也会产生类似的结果。方法:回顾性分析连续行切开复位和假体周围特异性多轴钢板固定的股骨PPF或膝关节翻修干周围假体间骨折患者。结果:14例,平均年龄85.4岁。80%的病例采用环扎术。在翻修柄周围平均固定8.6个皮质,总螺钉密度为1:2或1:3。4名患者失去了行走能力,4名患者出现了术后局部并发症。除1例在住院期间死亡外,其余患者均实现骨愈合。剩下的13例存活了第一年的随访。结论:STKA PPFs是影响体弱患者的一个新兴且具有挑战性的问题。尽管并发症发生率高,但多轴锁定钢板的治疗提供了稳定的固定,允许早期活动。
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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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