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Adequate bone healing after supplementary fixation of periprosthetic total knee arthroplasty fractures using Luque cerclage wiring: a retrospective case series

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Abstract

Purpose

Cerclage wiring is a well-known supplemental fixation technique that can be used in many types of fractures. With the tendency toward minimally invasive approaches in the management of periprosthetic total knee arthroplasty (TKA) fractures, and with absence of a dedicated study that reports the results of cerclage wiring in TKA fractures in particular, the aim of this retrospective study is to report the outcomes of supplementary cerclage wiring using simple Luque wires in fractures of distal femur associated with TKA.

Method

Eighteen cases, with a mean age of 77.2 years had complete follow-up data and had their radiographs and clinical data assessed for this study. Patients received cerclage wiring along with plates, retrograde nailing or around cracked femoral shaft overlying revision TKA femoral stem during the surgical management of periprosthetic TKA distal femur fractures.

Results

Fracture healing with adequate callus formation occurred in all 18 cases at a mean of 11.4 weeks postoperatively. None of the cases had any vascular injury, and after a mean clinical follow-up of 51 weeks, none of the cases had nonunion or hardware complications. One case had postoperative periprosthetic infection that developed 8 months after full fracture healing and had a two-stage revision using revision stemmed TKA and protective cerclage wiring with successful eradication of infection.

Conclusion

Supplementary cerclage wiring in distal femur TKA fractures can aid in enhanced bone healing with minimal complications, provided that adequate reduction and rigid fixation were achieved. This study reflects the level of evidence IV.

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Data availability

All data generated or analyzed during this study are included in this published article. The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Geisinger Medical Center, Geisinger Musculoskeletal Institute, 100 N Academy Ave, Danville, PA, 17821, USA

    Ahmed Nageeb Mahmoud, Maria F. Echeverry-Martinez & Daniel Scott Horwitz

  2. Department of Orthopedic Surgery, Ain Shams University, Cairo, Egypt

    Ahmed Nageeb Mahmoud

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  1. Ahmed Nageeb Mahmoud
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Contributions

Conceptualization was performed by DSH; investigation was conducted by ANM and MFEM; writing was done by ANM; writing—review and supervision was provided by DSH. All authors read and approved the final manuscript.

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Correspondence to Ahmed Nageeb Mahmoud.

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The authors have no conflict of interest to declare that are relevant to the content of this article.

Consent to participate

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Declaration of HELSINKI and its later amendments or comparable ethical standards. The study protocol was approved by the Institutional Review Board of GMC.

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Mahmoud, A.N., Echeverry-Martinez, M.F. & Horwitz, D.S. Adequate bone healing after supplementary fixation of periprosthetic total knee arthroplasty fractures using Luque cerclage wiring: a retrospective case series. Eur J Orthop Surg Traumatol 34, 389–395 (2024). https://doi.org/10.1007/s00590-023-03665-0

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  • DOI: https://doi.org/10.1007/s00590-023-03665-0

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