Distal femoral fracture during primary total knee arthroplasty

Journal of Orthopaedic Surgery
L A DelasottaA Ong

Abstract

To review 6 cases of periprosthetic distal femoral fracture during total knee arthroplasty (TKA). Of 778 women and 691 men who underwent primary TKAs using posterior-stabilised (n=1240), cruciate-retaining (n=165), or semiconstrained (n=64) implant, 5 women and one man with a mean age of 73.3 years and a mean body mass index of 31.6 kg/m(2) sustained an intra-operative periprosthetic distal femoral fracture and were followed up for a mean of 12.8 (range, 2-39) months. Respectively in patients with a posterior-stabilised, cruciate-retaining, or semi-constrained implant, the intra-operative fracture rates were 0.32%, 0%, and 3.13%. For women, the respective rates were 0.46%, 0%, and 5.10%. Intra-operative fracture was 9.69 times (p=0.03) more likely to occur in patients with a semi-constrained implant than those with a posterior-stabilised implant, and was 4.44 times (p=0.22) more likely to occur in women than in men. Half of the fractures occurred during the trial phase when the tibia was reduced onto the femur, and half during final prosthesis implantation. Distal femoral fracture during primary TKA is rare and associated with the use of a semiconstrained implant. Preserving as much bone in the distal femur is advised.

References

Apr 10, 1999·The Orthopedic Clinics of North America·M J Stuart, A D Hanssen
Dec 13, 2002·The Journal of Arthroplasty·Jill J Gelinas, Michael D Ries
May 12, 2009·Clinical Orthopaedics and Related Research·Kris J AldenGeorge J Haidukewych
Jan 26, 2011·Clinical Orthopaedics and Related Research·Aaron J JohnsonMichael A Mont

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Citations

Aug 12, 2020·Knee Surgery & Related Research·Prabhudev Prasad PurudappaSenthil Nathan Sambandam
Jan 15, 2021·Orthopedic Research and Reviews·Mina W MorcosEdward M Vasarhelyi
Sep 9, 2021·Zeitschrift für Orthopädie und Unfallchirurgie·Michael MüllerRobert Hube

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