J Korean Fract Soc.  2011 Apr;24(2):206-211. 10.12671/jkfs.2011.24.2.206.

Treatment of Peri-prosthetic Fracture about Total Knee Replacement

• Yoon SH
• Oh CW

• KMID: 2183866
• DOI: http://doi.org/10.12671/jkfs.2011.24.2.206

Abstract

No abstract available.

MeSH Terms

Arthroplasty, Replacement, Knee

Figure

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  Fig. 1 Lewis and Rorabeck classification of supracondylar periprosthetic femoral fracture classification. Type I: Undisplaced fracture, prosthesis stable. Type II: Displaced fracture, prosthesis stable. Type III: Unstable prosthesis with or without fracture displacement.

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  Fig. 2 Anteroposterior and lateral views of supracondylar periprosthetic femoral fracture classification by Su et al. Type I: Fracture proximal to femoral knee component. Type II: Fracture originating at the proximal aspect of the femoral knee component and extending proximally. Type III: Any part of the fracture line is distal to the upper edge of the anterior flange of the femoral knee component.

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  Fig. 3 Classification for periprosthetic fractures of the tibia associated with total knee arthroplasty. There are four types, subclassified as A (prosthesis radiographically well fixed), B (loose), and C (intraoperative). Type I fracture involves the tibial plateau, type II fracture is adjacent to the prosthetic stem, type III fracture is distal to the stem, and type IV fracture involves the tibial tubercle.

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  Fig. 4 (A) Initial anteroposterior radiograph shows a type II periprosthetic supracondylar femoral fracture. (B) MIPO procedure was performed with a precontoured locking plate application. (C) Immediate postoperative AP view. (D) AP and lateral radiographs show a good healing at the final follow-up.

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  Fig. 5 (A) Anteroposterior radiograph shows a periprosthetic fracture starting proximal to the femoral component. (B) Closed reduction and fixation was performed using a retrograde nail. (C) Fracture was healed uneventfully at 10 month postoperatively.

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  Fig. 6 (A) Type III periprosthetic tibia fracture in a 67 year-old lady with rheumatoid arthritis. (B, C) Bilateral locking plate was applied using minimally invasive plate osteosynthesis (MIPO) technique. (D, E) The fracture was united with good function.

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