Femoral periprosthetic fractures above TKA are commonly treated with retrograde intramedullary nailing (IMN). This study determined if TKA design and liner type affect the minimum knee flexion required for retrograde nailing through a TKA. Twelve cadaveric specimens were prepared for six single radius (SR) TKAs and six asymmetric medial pivot (MP) TKAs. Trials with 9mm polyethylene liners were tested with cruciate retaining (CR), cruciate substituting (CS) and posterior stabilizing (PS) types. The knee was extended to identify the minimum knee flexion required to allow safe passage of the opening reamer while maintaining an optimal fluoroscopic starting point for retrograde nailing. Furthermore, the angle of axis deviation between the reamer and the femoral shaft was calculated from fluoroscopic images.Introduction
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