Periprosthetic distal femur fractures around total knee replacements: A comprehensive review

Talal Al-Jabri; Mohamed Ridha; Robert Allan McCulloch; Chethan Jayadev; Babar Kayani; Peter V Giannoudis

doi:10.1016/j.injury.2023.02.037

Periprosthetic distal femur fractures around total knee replacements: A comprehensive review

Injury. 2023 Apr;54(4):1030-1038. doi: 10.1016/j.injury.2023.02.037. Epub 2023 Feb 22.

Authors

Talal Al-Jabri¹, Mohamed Ridha², Robert Allan McCulloch², Chethan Jayadev³, Babar Kayani⁴, Peter V Giannoudis⁵

Affiliations

¹ Trauma and Orthopaedic Surgery, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK; Joint Reconstruction Unit, The Royal National Orthopaedic Hospital, London, Stanmore HA7 4LP, UK; King Edward VII's Hospital, 5-10 Beaumont Street, Marylebone, London W1G 6AA, UK. Electronic address: tjresearcharticles@hotmail.com.
² Joint Reconstruction Unit, The Royal National Orthopaedic Hospital, London, Stanmore HA7 4LP, UK.
³ Joint Reconstruction Unit, The Royal National Orthopaedic Hospital, London, Stanmore HA7 4LP, UK; King Edward VII's Hospital, 5-10 Beaumont Street, Marylebone, London W1G 6AA, UK.
⁴ Department of Trauma and Orthopaedic Surgery, University College Hospital, 235 Euston Road, Fitzrovia, London NW1 2BU, UK.
⁵ Academic Department of Trauma and Orthopaedic Surgery, School of Medicine, University of Leeds, Clarendon Wing, Floor D, Great George Street, Leeds General Infirmary, Leeds LS1 3EX, UK; NIHR Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds, UK.

PMID: 36854630
DOI: 10.1016/j.injury.2023.02.037

Abstract

With a growing number of patients undergoing total knee replacements globally, coupled with an elderly population, the incidence of periprosthetic fractures around total knee replacements is increasing. As such, this is a highly topical subject that is gaining increasing interest within the orthopaedic community. This review provides a narrative synthesis of the most contemporary literature regarding distal femoral periprosthetic fractures. We review the related epidemiology, initial patient evaluation, the evolution and relevance of the classification systems and treatment options, particularly related to endoprosthetics and hybrid fixation constructs. The latest orthopaedic evidence related to this topic has been included.

Keywords: Endoprosthetic reconstruction; Hybrid fixation; Periprosthetic fracture; Total knee replacement.

Publication types

Review
Practice Guideline

MeSH terms

Aged
Arthroplasty, Replacement, Knee* / adverse effects
Femoral Fractures* / etiology
Femoral Fractures, Distal*
Femur / surgery
Fracture Fixation, Internal / adverse effects
Humans
Periprosthetic Fractures* / etiology