Open AccessPeriprosthetic Distal Femur Fracture after Total Knee Arthroplasty: A Systematic Review
Author(s) -
Ebraheim Nabil A,
Kelley Leanne H,
Liu Xiaochen,
Thomas Ian S,
Steiner Robert B,
Liu Jiayong
Publication year - 2015
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.12199
Subject(s) - periprosthetic , intramedullary rod , medicine , surgery , femur , femur fracture , arthroplasty , orthopedic surgery , osteosynthesis , femoral fracture , fixation (population genetics) , population , environmental health
This study was designed to itemize and analyze the classification of fracture types and their corresponding outcomes in an attempt to provide a better understanding of the current treatment methods. Two PubM ed searches were performed using the words “periprosthetic distal femur fracture” and “periprosthetic supracondylar femur fracture” in studies that were published in the previous 10 years (2004–2014). Data from 41 articlesthat met the general inclusion criteria, were collected and categorized into fracture type and treatment method groupings. Healing outcome and complications were the two parameters used to analyze the data. Treatment techniques were grouped in the following categories: locking plate, non‐locking plate, intramedullary nail/rod, screw, blade plate, cerclage wires, allograft, external fixation, revision arthroplasty, non‐operative, and other. Classification systems by Lewis and Rorabeck, the Association for Osteosynthesis/Orthopedic Trauma Association ( AO / OTA ), S u et al ., N eer et al ., K im et al ., B ackstein et al ., and the S ociété F rançaise de C hirurgie O rthopédique et T raumatologique were reported. In total 448 fractures were identified, of which Rorabeck type II was the most common fracture studied. The two most successful treatment options for periprosthetic distal femur fractures were locking plate (87%) and intramedullary nail/rod (84%). The most frequent complications associated with periprosthetic distal femur fractures included non/mal/delayed union and the need for revision. Locking plates used to treat Rorabeck type II fractures had a complication rate of 35% and those treated with intramedullary nailing had a higher complication rate of 53%. In conclusion, the most frequent type of periprosthetic distal femur fracture after total knee arthroplasty was Rorabeck type II . The most common treatments for these types of fractures are locked plating and intramedullary nailing, with similar healing rates of 87% and 84%, respectively. However, the complication rate for locked plating was lower than for intramedullary nailing.