Intra-operative periprosthetic fractures associated with press fit stems in revision total knee arthroplasty: incidence, management, and outcomes

J Arthroplasty. 2013 Sep;28(8):1310-3. doi: 10.1016/j.arth.2012.10.003. Epub 2013 Mar 20.

Abstract

The purpose of this study is to report the incidence, management, and outcomes of periprosthetic fractures associated with the insertion of press-fit stems during revision total knee arthroplasty (TKA). Immediate and six week post-operative radiographs from 634 stemmed implants (307 femoral, 327 tibial) from 420 consecutive revision TKAs were reviewed. Sixteen tibial (4.9%) and 3 femoral (1%) fractures (combined incidence 3.0%) were identified. All healed uneventfully without operative intervention, with no evidence of implant loosening at a mean of 23 months (range 12 to 47 months). The technique of tightly press fitting stems into the diaphysis is associated with a small rate (3%) of periprosthetic fractures; most were non or minimally displaced, all healed uneventfully with non-operative management and were not associated with implant loosening.

Keywords: arthroplasty; complications; fracture; knee; periprosthetic; revision.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Arthroplasty, Replacement, Knee / methods
  • Disease Management
  • Female
  • Femur / injuries
  • Humans
  • Incidence
  • Intraoperative Complications / epidemiology
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery*
  • Knee Prosthesis / adverse effects*
  • Male
  • Middle Aged
  • Periprosthetic Fractures / epidemiology*
  • Periprosthetic Fractures / etiology
  • Prosthesis Failure
  • Radiography
  • Reoperation
  • Retrospective Studies
  • Risk Factors
  • Tibia / injuries
  • Treatment Outcome