Compress® Periprosthetic Fractures: Interface Stability and Ease of Revision
Periprosthetic fractures after massive endoprosthetic reconstructions pose a reconstructive challenge and jeopardize limb preservation. Compressive osseointegration technology offers the promise of relative ease of prosthetic revision, since fixation is achieved by means of a short intramedullary device. We retrospectively reviewed the charts of 221 patients who had Compress® devices implanted in two centers between December, 1996 and December, 2008. The mean followup was 50 months (range, 1–123 months). Six patients (2.7%) sustained periprosthetic fractures and eight (3.6%) had nonperiprosthetic ipsilateral limb fractures occurring from 4 to 79 months postoperatively. All periprosthetic fractures occurred in patients with distal femoral implants (6/154, 3.9%). Surgery was performed in all six patients with periprosthetic femur fractures and for one with a nonperiprosthetic patellar fracture. The osseointegrated interface was radiographically stable in all 14 cases. All six patients with periprosthetic fracture underwent limb salvage procedures. Five patients had prosthetic revision; one patient who had internal fixation of the fracture ultimately underwent amputation for persistent infection. Periprosthetic fractures involving Compress® fixation occur infrequently and most can be treated successfully with further surgery. When implant revision is needed, the bone preserved by virtue of using a shorter intramedullary Compress® device as compared to conventional stems, allows for less complex surgery, making limb preservation more likely.
Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
- Compress® Periprosthetic Fractures: Interface Stability and Ease of Revision
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- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Clinical Orthopaedics and Related Research®
Volume 467, Issue 11 , pp 2800-2806
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- 2. Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- 1. UCSF Helen Diller Family Comprehensive Cancer Center, Orthopaedic Oncology Service, 1600 Divisadero Street, 4th Floor, San Francisco, CA, 94115-1939, USA