Distal Femoral Fracture during Primary Total Knee Arthroplasty

Purpose. To review 6 cases of periprosthetic distal femoral fracture during total knee arthroplasty (TKA). Methods. Of 778 women and 691 men who underwent primary TKAs using posterior-stabilised (n=1240), cruciate-retaining (n=165), or semi-constrained (n=64) implant, 5 women and one man with a mean...

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Main Authors: Lawrence A Delasotta, Fabio Orozco, Adam G Miller, Zachary Post, Alvin Ong
Format: Article
Language:English
Published: SAGE Publishing 2015-08-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/230949901502300218
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author Lawrence A Delasotta
Fabio Orozco
Adam G Miller
Zachary Post
Alvin Ong
author_facet Lawrence A Delasotta
Fabio Orozco
Adam G Miller
Zachary Post
Alvin Ong
author_sort Lawrence A Delasotta
collection DOAJ
description Purpose. To review 6 cases of periprosthetic distal femoral fracture during total knee arthroplasty (TKA). Methods. Of 778 women and 691 men who underwent primary TKAs using posterior-stabilised (n=1240), cruciate-retaining (n=165), or semi-constrained (n=64) implant, 5 women and one man with a mean age of 73.3 years and a mean body mass index of 31.6 kg/m 2 sustained an intra-operative periprosthetic distal femoral fracture and were followed up for a mean of 12.8 (range, 2–39) months. Results. Respectively in patients with a posterior-stabilised, cruciate-retaining, or semi-constrained implant, the intra-operative fracture rates were 0.32%, 0%, and 3.13%. For women, the respective rates were 0.46%, 0%, and 5.10%. Intra-operative fracture was 9.69 times (p=0.03) more likely to occur in patients with a semi-constrained implant than those with a posterior-stabilised implant, and was 4.44 times (p=0.22) more likely to occur in women than in men. Half of the fractures occurred during the trial phase when the tibia was reduced onto the femur, and half during final prosthesis implantation. Conclusion. Distal femoral fracture during primary TKA is rare and associated with the use of a semi-constrained implant. Preserving as much bone in the distal femur is advised.
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spelling doaj.art-774f2383f58b45c0b77fcf3e121cd1b72022-12-22T02:37:13ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902015-08-012310.1177/230949901502300218Distal Femoral Fracture during Primary Total Knee ArthroplastyLawrence A Delasotta0Fabio Orozco1Adam G Miller2Zachary Post3Alvin Ong4 Department of Radiology, Mount Sinai Medical Center, Miami Beach, FL, USA Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USAPurpose. To review 6 cases of periprosthetic distal femoral fracture during total knee arthroplasty (TKA). Methods. Of 778 women and 691 men who underwent primary TKAs using posterior-stabilised (n=1240), cruciate-retaining (n=165), or semi-constrained (n=64) implant, 5 women and one man with a mean age of 73.3 years and a mean body mass index of 31.6 kg/m 2 sustained an intra-operative periprosthetic distal femoral fracture and were followed up for a mean of 12.8 (range, 2–39) months. Results. Respectively in patients with a posterior-stabilised, cruciate-retaining, or semi-constrained implant, the intra-operative fracture rates were 0.32%, 0%, and 3.13%. For women, the respective rates were 0.46%, 0%, and 5.10%. Intra-operative fracture was 9.69 times (p=0.03) more likely to occur in patients with a semi-constrained implant than those with a posterior-stabilised implant, and was 4.44 times (p=0.22) more likely to occur in women than in men. Half of the fractures occurred during the trial phase when the tibia was reduced onto the femur, and half during final prosthesis implantation. Conclusion. Distal femoral fracture during primary TKA is rare and associated with the use of a semi-constrained implant. Preserving as much bone in the distal femur is advised.https://doi.org/10.1177/230949901502300218
spellingShingle Lawrence A Delasotta
Fabio Orozco
Adam G Miller
Zachary Post
Alvin Ong
Distal Femoral Fracture during Primary Total Knee Arthroplasty
Journal of Orthopaedic Surgery
title Distal Femoral Fracture during Primary Total Knee Arthroplasty
title_full Distal Femoral Fracture during Primary Total Knee Arthroplasty
title_fullStr Distal Femoral Fracture during Primary Total Knee Arthroplasty
title_full_unstemmed Distal Femoral Fracture during Primary Total Knee Arthroplasty
title_short Distal Femoral Fracture during Primary Total Knee Arthroplasty
title_sort distal femoral fracture during primary total knee arthroplasty
url https://doi.org/10.1177/230949901502300218
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AT adamgmiller distalfemoralfractureduringprimarytotalkneearthroplasty
AT zacharypost distalfemoralfractureduringprimarytotalkneearthroplasty
AT alvinong distalfemoralfractureduringprimarytotalkneearthroplasty