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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 25, Issue 9, pp 2921–2928 | Cite as

Similar outcomes of locking compression plating and retrograde intramedullary nailing for periprosthetic supracondylar femoral fractures following total knee arthroplasty: a meta-analysis

  • Young-Soo Shin
  • Hyun-Jung Kim
  • Dae-Hee LeeEmail author
Knee

Abstract

Purpose

This meta-analysis was designed to compare clinical outcomes, including knee scale score and nonunion rate, of patients with periprosthetic supracondylar fractures of the distal femur after total knee arthroplasty (TKA) who were treated using locking compression plates and retrograde intramedullary nails.

Methods

Studies were included in this meta-analysis if they compared clinical outcomes, including operation time, Knee Society Score (KSS), time to union, nonunion rate, and revision rate due to nonunion, in patients who underwent locking compression plate or retrograde intramedullary nail for periprosthetic distal femur fractures following TKA.

Results

Eight studies were included in this meta-analysis. Mean operation time was 11 min shorter (95 % CI −9.56 to 31.33 min; n.s.) and KSS one point higher (95 % CI −8.88 to 11.10; n.s.) with retrograde intramedullary nail than with locking compression plate, but these differences were not statistically significant. The two groups were also similar in mean time to union (0.46 weeks 95 % CI −1.17 to 2.08 weeks; n.s.), the proportion of subjects with nonunion (OR 0.83, 95 % CI 0.26–2.60; n.s.) and the proportion that underwent revision surgery (OR 0.88, 95 % CI 0.32–2.40; n.s.).

Conclusions

Clinical outcomes, including nonunion and revision rates, were similar in patients who underwent locking compression plate and retrograde intramedullary nail fixation for periprosthetic supracondylar femoral fracture following TKA. Orthopaedic surgeons must train to master both the retrograde intramedullary nail and locking compression plate techniques because both approaches can be considered for periprosthetic distal femur fracture after TKA as they have similar clinicoradiologic outcomes.

Level of evidence

II.

Keywords

Total knee arthroplasty Periprosthetic fracture Distal femur Locking plate Intramedullary nail 

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2016

Authors and Affiliations

  1. 1.Department of Orthopedic SurgerySeoul Veterans HospitalSeoulKorea
  2. 2.Department of Preventive MedicineKorea University College of MedicineSeoulKorea
  3. 3.Department of Orthopaedic Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea

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