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Periprosthetic Fractures of the Knee Above Total Knee Joint Arthroplasty

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European Surgical Orthopaedics and Traumatology

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Abstract

Periprosthetic fractures of the distal femur above total knee arthroplasty are uncommon and their prevalence is between 0.3%–2.5%. These fractures present a challenging surgical problem and the ideal treatment is still controversial. During the last few years the incidence of such fractures has increased concomitantly due to both the growing number of knee joint replacements and the increasing life span of the patients. Rorabeck’s classification is the most commonly used for these fractures. It is based on the location and degree of displacement of the fracture and the stability of the prosthesis as follow: Type I – the fracture is undisplaced and the prosthesis is stable; Type II – the fracture is displaced and the prosthesis is stable; Type III – the fracture is either displaced or undisplaced but the prosthesis is loose and unstable. Treatment consists of stable fixation of the Type I or II fractures by either Locking Compression Plates (LCP) or the Less Invasive Stabilization System (LISS) plates or by a retrograde intramedullary nail and in Type III by revison total knee arthroplasty with the use of bone grafts and augments combined with reduction and stable fixation of the fracture. We present the various pathologies and treatment modalities for management of such periprosthetic femoral fractures above total knee arthroplasty.

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Author information

Authors and Affiliations

  1. Departments of Orthopaedic Surgery and Traumatology, Western Galilee Hospital, Nahariya, Israel

    Gershon Volpin

  2. Kaplan Hospital Rehovot, Rehovot, Israel

    Chanan Tauber

  3. Hille Yafe Hospital, Hadera, Israel

    Roger Sevi

  4. Department of Orthopaedic Surgery and Traumatology, Western Galilee Hospital, Nahariya, Israel

    Haim Shtarker

Authors
  1. Gershon Volpin
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  2. Chanan Tauber
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  3. Roger Sevi
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  4. Haim Shtarker
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Corresponding author

Correspondence to Gershon Volpin .

Editor information

Editors and Affiliations

  1. Royal National Orthopaedic Hospital, Stanmore, United Kingdom

    George Bentley

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© 2014 EFORT

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Volpin, G., Tauber, C., Sevi, R., Shtarker, H. (2014). Periprosthetic Fractures of the Knee Above Total Knee Joint Arthroplasty. In: Bentley, G. (eds) European Surgical Orthopaedics and Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34746-7_138

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  • DOI: https://doi.org/10.1007/978-3-642-34746-7_138

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-34745-0

  • Online ISBN: 978-3-642-34746-7

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