$supracondylar fracture surgery video$

All the cases were followed-up for a mean duration of 6.35 years (range 6months–15 years).Ĭause of periprosthetic fracture & time interval: 13 (25%) fractures occurred intra-operatively, 36 (71%) fractures occurred after a trivial trauma and only 2 (4%) fractures occurred due to a road traffic accident. The mean age of all patients was 65.89 years. There were 13 (25%) male patients and 38 (75%) female patients, 12 (23%) patients were of age 60 years old. The goal of treatment was to obtain and maintain good postoperative fracture alignment and stability to allow early range of motion.ĭemographic profile: This is a retrospective review of 51 cases of periprosthetic fractures following total knee arthroplasty treated from the year 2000–2018. 8 While Felix 3 and Goldberg 9 classification systems were used to classify periprosthetic fracture around tibial and patellar site respectively. Supracondylar femoral fractures after total knee arthroplasty were classified by Lewis and Rorabeck. All periprosthetic fractures were classified according to the prevalent classification system.

$supracondylar fracture surgery video$

The functional status of the patient before periprosthetic fracture was assessed from the records and compared with the latest follow-up using Knee Society Score (KSS) and Oxford Knee Score (OKS). Post operatively, Sequential x-rays of the knee were taken to asses union, malunion, nonunion and any sign of implant failure. The details of revision surgery were also recorded from the operative notes in terms of implant used or any additional procedure such as bone grafting, revision total knee arthroplasty with semiconstrained or fully constrained & distal femur replacement. Type of primary prosthesis, interval between TKA and periprosthetic fracture, type of fracture, prosthesis stability and mode of fixation of fracture, any revision surgery and complication were noted. Diagnosis was made on the basis of clinical examination and radiographic evaluation of all the patients. Patients with incomplete records and those who died or did not come for follow up were excluded out. All patients with periprosthetic fracture that occurred during intraoperative period & following primary or revision TKA were included in the study. The data was analysed in terms of clinical and functional outcome. Out of 7390 primary cemented TKAs performed during 2000–2018, 51 cases diagnosed with periprosthetic fracture were enrolled and underwent surgical intervention. It was a retrospective study which was conducted at high volume arthroplasty centre in northern part of India. Thus this study was conducted to analyze the results of various methods of treatment of periprosthetic fractures following TKA and to form the optimal treatment guidelines for fixation or revision.

$supracondylar fracture surgery video$

So any form of treatment has a high rate of failure. Similarly, revision surgery itself is a big challenge in the presence of periprosthetic fracture. These factors coupled with osteoporosis makes the success of internal fixation unpredictable. 2, 5, 6, 7 Furthermore, it is often difficult to ascertain whether the prosthesis is well fixed or loose. The most appropriate treatment to achieve a satisfactory outcome is dependent on a number of factors that include degree of displacement, adequacy of bone stock, stability of prosthesis and the medical fitness of the patient. The management option varies from conservative to internal fixation or revision surgery.

$supracondylar fracture surgery video$

Loosening of implant and osteolysis also predispose to these fractures. Iatrogenic factors include Anterior femoral notching & malalignment. 4 Risk factors associated with periprosthetic fractures are patients related that include osteoporosis, rheumatoid arthritis, seizure disorder, Parkinson’s disease use of corticosteroids, old age and female sex. 3 Patellar periprosthetic fractures are more common with patella resurfacing arthroplasties but overall incidence is 0.68%. 2 Tibial periprosthetic fractures are further less common with incidence of about 0.4% with primary TKA and a higher incidence after revision TKA. Supracondylar fractures are the commonest periprosthetic fracture with incidence further increases to 1.6–38% after revision TKA. It is often difficult to ascertain whether the prosthesis is well fixed or loose. 1 But these injuries are often complex and challenging for the surgeons due to ageing population in conjunction with severe osteoporosis. Periprosthetic fractures around total knee arthroplasty are relatively rare complication comprises to 0.3–2.5%. This further has increased the number of revision surgeries due to likelihood postoperative complications.

$supracondylar fracture surgery video$

Increase in the life expectancy and functional demands of the patients have resulted in substantial increase in the frequency of total knee arthroplasty (TKA).

$supracondylar fracture surgery video$

Supracondylar fracture surgery video