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Revision Total Knee Arthroplasty for the Management of Periprosthetic Fractures

Kuzyk, Paul R.T. MD, MASc, FRCSC; Watts, Evan MD, MSc, FRCSC; Backstein, David MD, MEd, FRCSC

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: September 2017 - Volume 25 - Issue 9 - p 624–633
doi: 10.5435/JAAOS-D-15-00680
Review Article

Periprosthetic fractures after total knee arthroplasty (TKA) can present reconstructive challenges. Not only is the procedure technically complex, but patients with these fractures may have multiple comorbidities, making them prone to postoperative complications. Early mobilization is particularly beneficial in patients with multiple comorbidities. Certain patient factors and fracture types may make revision TKA the ideal management option. Periprosthetic fractures around the knee implant occur most frequently in the distal femur, followed by the tibia and the patella. Risk factors typically are grouped into patient factors (eg, osteoporosis, obesity) and surgical factors (eg, anterior notching, implant malposition). Surgical options for periprosthetic fractures that involve the distal femur or proximal tibia include reconstruction of the bone stock with augments or metal cones or replacement with an endoprosthesis.

From the Granovsky Gluskin Department of Orthopedics, Sinai Health System, University of Toronto, Toronto, Ontario, Canada.

Dr. Kuzyk or an immediate family member serves as a paid consultant to Avenir Medical and has received research or institutional support from Stryker and Zimmer Biomet. Dr. Backstein or an immediate family member has received royalties from MicroPort Orthopedics; is a member of a speakers’ bureau or has made paid presentations on behalf of MicroPort Orthopedics and Zimmer Biomet; serves as a paid consultant to Intellijoint Surgical, MicroPort Orthopedics, and Zimmer Biomet; has stock or stock options held in Intellijoint Surgical; and has received research or institutional support from Zimmer Biomet. Neither Dr. Watts nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

Received December 03, 2015

Accepted June 11, 2016

© 2017 by American Academy of Orthopaedic Surgeons
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