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. 2018 Oct-Dec;9(4):289-291.
doi: 10.1016/j.jcot.2017.10.001. Epub 2017 Oct 5.

Is the fracture pattern in periprosthetic fractures around the knee related with the anterior femoral notch?

José Carlos Minarro  1 , María Teresa Urbano-Luque  2 , Alberto López-Jordán  1 , Manuel Jesús López-Pulido  1 , Ángel González-Fernández  1 , Alberto Damián Delgado-Martínez  3
Affiliations

Is the fracture pattern in periprosthetic fractures around the knee related with the anterior femoral notch?

José Carlos Minarro et al. J Clin Orthop Trauma. 2018 Oct-Dec.

Abstract

Introduction: Periprosthetic fractures around the knee (PPF) are a devastating complication of total knee arthroplasty (TKA). Anterior femoral notching during TKA is considered a risk factor for PPF. The aim of this paper is to determine if an anterior femoral notch after total knee arthroplasty may affect the fracture pattern when a PPF appears postoperatively.

Material and methods: 50 patients diagnosed in our centre of a PPF from January 2010 to December 2013 were retrospectively enrolled. 100 patients who underwent a total knee arthroplasty without fracture were randomly obtained as a control group. Evidence of the notch was searched in both groups in postoperative X-rays. In the PPF group, distance from the shield of the femoral component to the most distal (d) and proximal (D) point of the fracture were measured.

Results: Two different groups were obtained: 1) d = 0 (33 out of 50 patients); the fracture is supposed to be related with the notch as it's a theoretically weaker area. 2) d > 0 (17 out of 50 patients); the fracture pattern has no relationship with the notch. Prevalence of patients suffering a fracture in the shield of the prosthesis (d = 0), was similar in both patients with notch (66,7%) and without it (68%).

Conclusions: In conclusion, fracture pattern is not related with the existence of a femoral notch in the clinical setting.

Keywords: Femoral notch; Fracture pattern; Knee; Periprosthetic fractures.

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Figures

Fig. 1
Fig. 1
An anteroposterior view of a periprosthetic fracture around the knee. (d) Shorter distance between the fracture line and the anterior shield of the prosthesis. (D) Longer distance between the fracture line and the anterior shield of the prosthesis. Both measurements were obtained on the AP X-ray view. The fracture pattern is considered to be related with the notch when d = 0.
See this image and copyright information in PMC

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