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The Journal of Bone and Joint Surgery 79:1100-13 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Periprosthetic Fractures Adjacent to Total Knee Implants. Treatment and Clinical Results*{dagger}

GERARD A. ENGH, M.D.{ddagger} and DEBORAH J. AMMEEN, B.S.{ddagger}, ARLINGTON, VIRGINIA

An Instructional Course Lecture, The American Academy of Orthopaedic Surgeons


   Introduction
 
The unique characteristics that predispose patients to periprosthetic fractures make treatment difficult and unpredictable. Severe osteoporosis makes fracture fixation precarious. The typical elderly and debilitated patient must be mobilized rapidly to avoid medical complications brought on by prolonged bed rest and inactivity. However, walking with protected weight-bearing often is impossible because of multiple-joint involvement, neurological disorders, and systemic illness.

In most instances, early and definitive treatment is preferable to a prolonged period of bed rest and inactivity. Periprosthetic fractures may occur intraoperatively or postoperatively. The best treatment technique depends on whether the fracture is identified intraoperatively or postoperatively as well as on its location and severity. Common fracture-repair techniques, such as those involving use of a plate and screws, intramedullary rods, and external fixators, have been associated with variable rates of success. This paper examines the role of different techniques for management of the fracture and revision of the component . . . [Full Text of this Article]


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D. A. Dennis
Periprosthetic Fractures Following Total Knee Arthroplasty
J. Bone Joint Surg. Am., January 1, 2001; 83(1): 120 - 120.
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