Abstract
Nineteen periprosthetic fractures above 835 total knee arthroplasties (748 primary and 87 revision) in an eight-year period (1992–1999) were studied retrospectively. In six cases the fracture was situated in the proximal metaphysis of the tibia, 11 cases in the femur and two cases in the patella. Fourteen fractures were intraoperative (9 fractures during primary implantation and 5 fractures during revision arthroplasty). Some intraoperative fractures were not observed either by the surgeon or in postoperative radiograph control. There was trauma in three cases (1 tibia, 1 femur, 1 patella). Two cases were secondary to osteolysis (1 patella, 1 femoral condyle). Non-operative treatment was performed in eight fractures (traction and/or cast bracing). Operative treatment was performed in 11 fractures (3 plate osteosynthesis, 1 external fixation, 7 internal fixation with screws).
The results of this study show that the greater part of the fractures occur intraoperatively in relation to revision arthroplasty and technical mistakes during the osteotomy, the component test, and aggressive impaction. Undetected fractures occur in radiograph control because of low quality or insufficient view of the bone around the prosthesis.
The abstracts were prepared by David P. Davlin. Correspondence should be addressed to him at the Orthopedic Clinic Bulovka, Budínova 2, 18081 Prague 8, Czech Republic.
