CLASSIFICATION OF PERIPROSTHETIC FRACTURES COMPLICATING TOTAL KNEE ARTHROPLASTY
Section snippets
SUPRACONDYLAR FRACTURES
Supracondylar fractures are the most common fractures occurring around total knee arthroplasties. The incidence has been reported as 0.3% to 2.5%. Factors that can predispose to these fractures include intraoperative notching of the femur, osteolysis, osteoporosis, rheumatoid arthritis, corticosteroid use, increased age, female sex, and certain neurologic disorders.1, 2, 3, 4, 7, 11, 12, 15, 16, 17
The classification system of Neer13 has been used for these fractures. This system was originated
TIBIAL FRACTURES
Periprosthetic fractures of the tibia occur infrequently. They may occur intraoperatively as a result of impaction of a prosthesis with a stem that impinges on the cortex. They can also be caused by inadequate preparation of seating holes for pegs or fins.5, 6 Malalignment of the tibial component has been associated with stress fracture of the tibia. Rand and Coventry14 reported on 15 patients with tibial fractures after total knee arthroplasty and found that most were associated with axial
PATELLAR FRACTURES
Patellar fractures complicating total knee arthroplasty may occur as a result of excessive bone removed during the resurfacing procedure, malposition of the component, and avascularity of the patella.5, 10 Several factors have been identified as being important in guiding management and allowing prognostication in the case of a periprosthetic patellar fracture. Probably the most important are the degree of displacement of the fracture, whether the extensor mechanism is intact or not, and how
CONCLUSION
Classification of orthopedic conditions is important to allow communication among researchers and clinicians, to guide treatment, and to provide insight into likely outcomes. Several classification systems exist in relation to periprosthetic fractures complicating total knee arthroplasty. The important factors in relation to these fractures are the anatomic location of the fracture, the degree of displacement, the status of the implant, and whether the extensor mechanism is intact. The authors
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Cited by (0)
Address reprint requests to Cecil H. Rorabeck, MD, London Health Science Centre, University Campus, 339 Windermere Road, London, Ontario, Canada N6A 5A5
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Department of Orthopaedic Surgery, London Health Sciences Centre, The University of Western Ontario, London, Ontario, Canada