Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Knee
Abstract number: 25382
PERIARTICULAR FRACTURES AFTER TOTAL KNEE REPLACEMENT
Oleg EISMONT, Alexandre BELETSKY, Pavel SKAKUN, Andrey PERESADA
Republican Scientific Practical Centre of Traumatology and Orthopaedic Surgery,
Minsk, Belarus, Minsk (BELARUS)
The aims of the investigation included the study of the causes, development of the
management, the evaluation of the results of the rehabilitation of the patients with
periprosthetic fractures of the femur after total knee replacement. The results of
treatment of 9 cases (0.6%) of periprosthetic fractures of the femur after 1568 cases
of total knee replacement were studied. All the patients were female aging from 55 to
76. A group of patients with implanted bicondylar no-hinged models was chosen for
the investigation. The results 2 to 7 years after the treatment were evaluated
according to the Knee Society Clinical Rating System. Periprosthetic fractures
occurred at the time of 10 days to 5 years after total knee replacement. In all the
cases an evidence of trauma was present. In 5 cases rheumatoid arthritis was
present. 4 cases had a femoral notch more than 3 mm. In 1 case total hip
replacement of the same leg had been performed. There were no cases with
prosthetic instability. An invasive surgical approach was used with open reduction
and plating including minimally-invasive implants. In all the cases union was
achieved with no axis deformities and an average loss of 10 degrees in the range of
motion. The basic causes of periprosthetic fractures of the femur after total knee
replacement are the middle age of the patients with concomitant osteoporosis,
rheumatoid arthritis, excessive femoral notch. An appropriate invasive surgical
approach is indicated in these cases.
138