Plaques verrouillées par voie mini-invasive dans les fractures périprothétiques tibiales sur prothèse totale du genou

Translated title of the contribution: Successful outcome with minimally invasive plate osteosynthesis for periprosthetic tibial fracture after total knee arthroplasty

H. J. Kim, K. C. Park, J. W. Kim, C. W. Oh, H. S. Kyung, Jong-Keon Oh, K. H. Park, S. D. Yoon

Research output: Contribution to journalArticle

Abstract

Introduction The incidence of periprosthetic fractures after total knee arthroplasty (TKA) is increasing, and treatment is becoming more necessary. In periprosthetic tibial fracture, the stem of the tibial component largely occupies the medullary canal of the proximal tibia, which limits the selection of implants. The purpose of this study was to evaluate the effectiveness of the minimally invasive plate osteosynthesis (MIPO) technique with locking plates for periprosthetic tibial fractures after TKA. Materials and methods Sixteen patients with periprosthetic tibial fracture after TKA were included. There were 6 type II and 10 type III fractures according to the Felix classification. Ten patients had fractures in the proximal metaphysis, and 6 in the diaphysis. MIPO using locking plates was performed on the medial side in 4 cases, the lateral side in 2 cases, and both in 10 cases. Radiographic results included time to union, alignment, and malunion. Clinical results included range of motion (ROM), functional activity data, Knee Society scores, and complications. Results Fourteen of 16 fractures achieved union at 17.1 weeks (range, 14–24) postoperatively. There were 2 failures that required a secondary procedure. Except one for 1 case with varus malunion, all had acceptable alignment. Mean ROM at the final follow-up was 108.8° (range, 15–135°), and 15 patients recovered pre-injury knee joint activity. Mean knee and function scores were 88.9 (range, 77–100) and 83.3 (range, 60–100), respectively. Knees with fewer than 8 cortices giving purchase to screws in the proximal segment showed higher failure rates (P = 0.025). Discussion MIPO with locking plates can achieve satisfactory results for periprosthetic tibial fractures after TKA. Rigid fixation of the proximal segment may be necessary for successful outcome. Level of evidence IV.

Original languageFrench
Number of pages1
JournalRevue de Chirurgie Orthopedique et Traumatologique
Volume103
Issue number2
DOIs
Publication statusPublished - 2017 Apr 1

Fingerprint

Periprosthetic Fractures
Knee Replacement Arthroplasties
Tibial Fractures
Articular Range of Motion
Knee
Diaphyses
Knee Joint
Tibia
Incidence
Wounds and Injuries

Keywords

  • Locking plate
  • Minimally invasive plate osteosynthesis
  • Periprosthetic tibial fracture
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Plaques verrouillées par voie mini-invasive dans les fractures périprothétiques tibiales sur prothèse totale du genou. / Kim, H. J.; Park, K. C.; Kim, J. W.; Oh, C. W.; Kyung, H. S.; Oh, Jong-Keon; Park, K. H.; Yoon, S. D.

In: Revue de Chirurgie Orthopedique et Traumatologique, Vol. 103, No. 2, 01.04.2017.

Research output: Contribution to journalArticle

Kim, H. J. ; Park, K. C. ; Kim, J. W. ; Oh, C. W. ; Kyung, H. S. ; Oh, Jong-Keon ; Park, K. H. ; Yoon, S. D. / Plaques verrouillées par voie mini-invasive dans les fractures périprothétiques tibiales sur prothèse totale du genou. In: Revue de Chirurgie Orthopedique et Traumatologique. 2017 ; Vol. 103, No. 2.
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abstract = "Introduction The incidence of periprosthetic fractures after total knee arthroplasty (TKA) is increasing, and treatment is becoming more necessary. In periprosthetic tibial fracture, the stem of the tibial component largely occupies the medullary canal of the proximal tibia, which limits the selection of implants. The purpose of this study was to evaluate the effectiveness of the minimally invasive plate osteosynthesis (MIPO) technique with locking plates for periprosthetic tibial fractures after TKA. Materials and methods Sixteen patients with periprosthetic tibial fracture after TKA were included. There were 6 type II and 10 type III fractures according to the Felix classification. Ten patients had fractures in the proximal metaphysis, and 6 in the diaphysis. MIPO using locking plates was performed on the medial side in 4 cases, the lateral side in 2 cases, and both in 10 cases. Radiographic results included time to union, alignment, and malunion. Clinical results included range of motion (ROM), functional activity data, Knee Society scores, and complications. Results Fourteen of 16 fractures achieved union at 17.1 weeks (range, 14–24) postoperatively. There were 2 failures that required a secondary procedure. Except one for 1 case with varus malunion, all had acceptable alignment. Mean ROM at the final follow-up was 108.8° (range, 15–135°), and 15 patients recovered pre-injury knee joint activity. Mean knee and function scores were 88.9 (range, 77–100) and 83.3 (range, 60–100), respectively. Knees with fewer than 8 cortices giving purchase to screws in the proximal segment showed higher failure rates (P = 0.025). Discussion MIPO with locking plates can achieve satisfactory results for periprosthetic tibial fractures after TKA. Rigid fixation of the proximal segment may be necessary for successful outcome. Level of evidence IV.",
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AU - Oh, C. W.

AU - Kyung, H. S.

AU - Oh, Jong-Keon

AU - Park, K. H.

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AB - Introduction The incidence of periprosthetic fractures after total knee arthroplasty (TKA) is increasing, and treatment is becoming more necessary. In periprosthetic tibial fracture, the stem of the tibial component largely occupies the medullary canal of the proximal tibia, which limits the selection of implants. The purpose of this study was to evaluate the effectiveness of the minimally invasive plate osteosynthesis (MIPO) technique with locking plates for periprosthetic tibial fractures after TKA. Materials and methods Sixteen patients with periprosthetic tibial fracture after TKA were included. There were 6 type II and 10 type III fractures according to the Felix classification. Ten patients had fractures in the proximal metaphysis, and 6 in the diaphysis. MIPO using locking plates was performed on the medial side in 4 cases, the lateral side in 2 cases, and both in 10 cases. Radiographic results included time to union, alignment, and malunion. Clinical results included range of motion (ROM), functional activity data, Knee Society scores, and complications. Results Fourteen of 16 fractures achieved union at 17.1 weeks (range, 14–24) postoperatively. There were 2 failures that required a secondary procedure. Except one for 1 case with varus malunion, all had acceptable alignment. Mean ROM at the final follow-up was 108.8° (range, 15–135°), and 15 patients recovered pre-injury knee joint activity. Mean knee and function scores were 88.9 (range, 77–100) and 83.3 (range, 60–100), respectively. Knees with fewer than 8 cortices giving purchase to screws in the proximal segment showed higher failure rates (P = 0.025). Discussion MIPO with locking plates can achieve satisfactory results for periprosthetic tibial fractures after TKA. Rigid fixation of the proximal segment may be necessary for successful outcome. Level of evidence IV.

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KW - Minimally invasive plate osteosynthesis

KW - Periprosthetic tibial fracture

KW - Total knee arthroplasty

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