Our Summary

This study is about periprosthetic knee fractures, which are becoming more common due to an aging population and increased knee replacements. These fractures are difficult for orthopedic surgeons to manage. The researchers reviewed recent studies on the causes, risks, diagnosis, treatment and outcomes of these fractures.

They found that proper treatment depends on correctly diagnosing the fracture and assessing the risk factors. Non-surgical treatment is rarely the best option. Surgical treatments like locking plate fixation, intramedullary nailing, and revision arthroplasty (a second knee replacement surgery) can be effective. The best surgical approach depends on the patient’s age, overall health, the specifics of the fracture, the quality of the bone, and the stability of the implant. Despite the potential for complications, all of these surgical treatments can lead to good results if chosen correctly for the right patient.

FAQs

  1. What factors influence the selection of a surgical approach for periprosthetic knee fractures?
  2. What are some of the surgical treatment options for periprosthetic knee fractures?
  3. Why is non-surgical treatment rarely the best option for periprosthetic knee fractures?

Doctor’s Tip

One helpful tip a doctor might tell a patient about knee replacement is to follow all post-operative instructions carefully, including physical therapy exercises and any restrictions on activities. It’s important to follow a proper rehabilitation program to help ensure a successful recovery and long-term function of the knee replacement. Additionally, maintaining a healthy weight and staying active can help reduce the risk of complications and improve overall outcomes following knee replacement surgery.

Suitable For

Patients who are typically recommended for knee replacement surgery are those who have severe knee pain and stiffness that limits their daily activities, have not experienced relief from other treatments such as medication or physical therapy, have arthritis or other degenerative joint diseases, and have a significant decrease in quality of life due to their knee condition. Additionally, patients should be in overall good health and have realistic expectations about the outcomes of the surgery.

Timeline

Timeline of a patient’s experience before and after knee replacement:

Before knee replacement:

  • Patient experiences chronic knee pain, stiffness, swelling, and limited range of motion
  • Patient consults with an orthopedic surgeon who recommends knee replacement surgery
  • Patient undergoes pre-operative testing and preparation for surgery
  • Patient may undergo physical therapy to strengthen the knee muscles and improve mobility before surgery

After knee replacement:

  • Patient undergoes knee replacement surgery, which typically takes a few hours
  • Patient spends a few days in the hospital for recovery and rehabilitation
  • Patient begins physical therapy to regain strength, flexibility, and mobility in the knee
  • Patient may require assistive devices such as crutches or a walker during the initial recovery period
  • Patient gradually increases physical activity and resumes daily activities with the guidance of healthcare providers
  • Patient continues with regular follow-up appointments with the orthopedic surgeon to monitor healing and progress
  • Over time, patient experiences improved knee function, reduced pain, and increased quality of life as a result of the knee replacement surgery.

What to Ask Your Doctor

  1. What are the risk factors for developing a periprosthetic knee fracture after a knee replacement surgery?
  2. How will the fracture be diagnosed and assessed in my specific case?
  3. What are the different surgical treatment options available for periprosthetic knee fractures, and which one would be most appropriate for me?
  4. How will the choice of treatment be determined based on my age, overall health, the specifics of the fracture, the quality of the bone, and the stability of the implant?
  5. What are the potential complications associated with each surgical treatment option?
  6. What can I expect in terms of recovery and rehabilitation after undergoing treatment for a periprosthetic knee fracture?
  7. Are there any long-term implications or risks associated with having a periprosthetic knee fracture and undergoing treatment for it?
  8. How often will follow-up appointments be necessary after treatment for a periprosthetic knee fracture?
  9. Are there any lifestyle changes or precautions I should take to prevent future periprosthetic knee fractures?
  10. Are there any alternative or complementary therapies that may help in the recovery process after treatment for a periprosthetic knee fracture?

Reference

Authors: Canton G, Ratti C, Fattori R, Hoxhaj B, Murena L. Journal: Acta Biomed. 2017 Jun 7;88(2S):118-128. doi: 10.23750/abm.v88i2-S.6522. PMID: 28657573