Review
Management of periprosthetic femur fracture after total knee arthroplasty
Wei Xuelei, Sun Jie, Ma Baotong
Published 2023-02-16
Cite as Chin J Orthop, 2023, 43(4): 269-276. DOI: 10.3760/cma.j.cn121113-20220911-00536
Abstract
Periprosthetic fracture of femur is the most common postoperative complication after total knee arthroplasty (TKA). Risk factors for periprosthetic fractures include female sex, osteoporosis/osteopenia, rheumatoid arthritis, osteoarthritis, neuromuscular disease, cognitive disorder, chronic use of corticosteroids, obesity, advanced age, infection, osteolysis around the prosthesis, knee joint ankyloses, notching of the anterior femoral cortex, etc. According to epidemiological research, the incidence of femoral periprosthetic fractures following TKA ranges from 0.3% to 2.5%. Lewis and Rorabeck classifications, the most commonly used classification of periprosthetic fractures of the femur, introduce the concept of prosthesis loosening and emphasize the ecessity of revision surgery. Other classifications include Su typing, Universal Typing System, and Rhee typing, the latest of which is the Kim typing proposed in 2022. Treatment strategies for periprosthetic femoral fractures after TKA include nonsurgical treatment, external fixation techniques, single-plate fixation, double-plate fixation, intramedullary nail fixation, and revision TKA and distal femur replacement. The purpose of this paper is to better guide the prevention and treatment of periprosthetic fractures after TKA by searching and analyzing relevant literature on periprosthetic fractures after TKA.
Key words:
Femur; Periprosthetic fractures; Arthroplasty, replacement, knee
Contributor Information
Wei Xuelei
Department of Orthopaedic Trauma, Tianjin Hospital, Tianjin University, Tianjin 300211, China
Sun Jie
Department of Orthopaedic Trauma, Tianjin Hospital, Tianjin University, Tianjin 300211, China
Ma Baotong
Department of Orthopaedic Trauma, Tianjin Hospital, Tianjin University, Tianjin 300211, China