Treatment of Periprosthetic Supracondylar Femur Fractures following Total Knee Arthroplasty: Minimally Invasive Technique using Locking Condylar Plate

ABSTRACT

PURPOSE: To evaluate clinical and radiological outcomes related to minimally invasive treatment of supracondylar periprosthetic fractures with locked condylar plates following total knee arthroplasty. MATERIALS AND METHODS: We studied 7 cases of periprosthetic supracondylar femoral fractures treated between January 2001 and June 2006. The mean patient age was 66 years (range 62~72 years). The mean follow-up duration was 21 months (range 12~41 months). The index operation implant was a posterior cruciate substitution implant without a stem. According to the Orthopedic Trauma Association (OTA) classification, all cases were 33A. RESULTS: Each case was treated using a locking condylar plate. The fracture was extended to the undersurface of the anterior flange of the femoral component. The locking condylar plate was fixed by minimally invasive percutaneous technique. The average time to bone union was 5 months (range 3~6 months) without additional bone grafting. The mean range of motion was 96 degrees, and the mean Hospital for Special Surgery (HSS) score was 75 points at last follow-up. The mean femorotibial angle at last follow-up was valgus 5 degrees. CONCLUSION: Minimally invasive percutaneous fixation using a locking condylar plate was a useful alternative to a retrograde femoral nail in repairing periprosthetic femoral fractures