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Triple fracture during rehabilitation after revision total knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The incidence of periprosthetic fractures after knee-joint implant revisions is increasing in prevalence. We present a method of treatment for a patient who sustained a triple fracture—a periprosthetic femur fracture, a patella fracture, and a tibial shaft fracture.

Methods

The femoral fracture was treated with a specially designed intramedullary nail, the patella fracture with a figure-of-eight suture, and the tibial shaft fracture by a minimal-invasive plate osteosynthesis using a percutaneous plating technique.

Results

Osseous consolidation was confirmed, and the patient presented a satisfying range of movement under full-weight-bearing conditions after mobilisation.

Conclusions

Simultaneous multiple periprosthetic fractures are a special challenge, and in situ coupling of the endoprosthesis with a slotted hollow nail presents a valuable option for the treatment.

Level of evidence

Level V, Expert opinion.

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References

  1. Ehlinger M, Adam P, Abane L, Rahme M, Moor BK, Arlettaz Y, Bonnomet F (2011) Treatment of periprosthetic femoral fractures of the knee. Knee Surg Sports Traumatol Arthrosc 19:1473–1478

    Article  PubMed  Google Scholar 

  2. Felix NA, Stuart MJ, Hanssen AD (1997) Periprosthetic fractures of the tibia associated with total knee arthroplasty. Clin Orthop Rel Res 345:113–124

    Article  Google Scholar 

  3. Healy WL, Siliski JM, Incavo SJ (1993) Operative treatment of distal femoral fractures proximal to total knee replacements. J Bone Joint Surg Am 75:27–34

    PubMed  CAS  Google Scholar 

  4. Herrera DA, Kregor PJ, Cole PA, Levy BA, Jönsson A, Zlowodzki M (2008) Treatment of acute distal femur fractures above a total knee arthroplasty: systematic review of 415 cases (1981–2006). Acta Orthop 79(1):22–27

    Article  PubMed  Google Scholar 

  5. Hopf C, Hopf T, Rompe JD (1996) Treatment concepts for fractures of the femur following total knee or hip endoprosthetic replacement. Unfallchirurg 99:31–37

    PubMed  CAS  Google Scholar 

  6. Meyer C, Alt V, Schroeder L, Heiss C, Schnettler R (2007) Treatment of periprosthetic femoral fractures by effective lengthening of the prosthesis. Clin Orthop Rel Res 463:120–127

    Google Scholar 

  7. Meyer C, Alt V, Heiss C, Kraus R, Szalay G, Schnettler R (2011) Intramedullary nailing of periprosthetic femoral fractures after revision for total knee endoprosthesis. Unfallchirurg 114:241–247

    Article  PubMed  CAS  Google Scholar 

  8. Mittlmeier T, Stöckle U, Perka C, Schaser KD (2005) Periprosthetic fractures following total knee total knee endoprosthesis. Unfallchirurg 108:481–496

    Article  PubMed  CAS  Google Scholar 

  9. Ortiguera CJ, Berry DJ (2004) Patellar fracture after total knee arthroplasty. J Bone Joint Surg 84-A:532–540

    Google Scholar 

  10. Parvizi J, Jain N, Schmidt AH (2008) Periprosthetic knee fractures. J Orthop Trauma 22:663–671

    Article  PubMed  Google Scholar 

  11. Rolston LR, Christ DJ, Halpern A, O′Connor PL, Ryan TG, Uggen WM (1995) Treatment of supracondylar fractures of the femur proximal to a total knee arthroplasty. J Bone Joint Surg 77-A:924–931

    Google Scholar 

  12. Rorabeck CH, Taylor JW (1999) Periprosthetic fractures of the femur complicating total knee arthroplasty. Orthop Clin North Am 30:265–277

    Article  PubMed  CAS  Google Scholar 

  13. Tanaka Y, Kobayashi T, Ohashi M, Kaneko D, Nemoto K (2007) A new operative procedure using a Küntscher nail for a periprosthetic supracondylar femoral fracture after revision total knee arthroplasty: a case report. Knee 14:59–62

    Article  PubMed  Google Scholar 

  14. Wenda K (2002) In-situ connection of a hollow medullary nail with the stem of knee prosthesis in a periprosthetic fracture. Unfallchirurg 105:19–22

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Christof Meyer.

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Meyer, C., Szalay, G., Alt, V. et al. Triple fracture during rehabilitation after revision total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22, 2662–2664 (2014). https://doi.org/10.1007/s00167-013-2538-4

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  • DOI: https://doi.org/10.1007/s00167-013-2538-4

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