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From the American Academy of Orthopaedic Surgeons

Knee Arthroscopy

Common Knee Injuries

Fractures of the Proximal Tibia

Surgical Treatment of Osteoarthritis of the Knee

Osteotomy and Unicompartmental Total Knee Arthroplasty

Save Your Knees!

Periprosthetic Fractures About the Knee
by Jay Parvizi, MD; Khalid Azzam, MD

More than 400,000 total knee arthroplasty (TKA) procedures are performed annually in the United States, most on elderly patients. With the increasing life expectancy and heightened activity levels of the elderly population, the number of patients who undergo TKA procedures will likely double over the course of the next decade and result in an increased incidence of periprosthetic knee fractures. The prevalence of these fractures varies considerably among fracture location, patient predisposition to risk factors, and intraoperative and postoperative fracture incidence. Treatment options vary based on the fracture type and whether the fracture is identified intraoperatively or postoperatively. Use of appropriate bone cuts, proper positioning and gentle impaction of the components, meticulous care in removal of components and cement, and avoidance of stress risers help prevent periprosthetic fractures about the knee. Surgical treatment can include the use of Rush rods, Zickel supracondylar rods, plate and screw fixation, or supracondylar intramedullary rods.

Keywords: periprosthetic fracture, patellar fracture, femoral fracture, tibial fracture, type I periprosthetic fracture, type II periprosthetic fracture, type III periprosthetic fracture

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