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Case Reports
. 2019 Dec 4;5(4):453-464.
doi: 10.1016/j.artd.2019.11.001. eCollection 2019 Dec.

Peri-implant fracture after dual-plating knee arthrodesis for failed total knee arthroplasty: case series

Michael Ransone  1 , Keith Fehring  2 , Brian Curtin  2 , J Bohannon Mason  2
Affiliations
Case Reports

Peri-implant fracture after dual-plating knee arthrodesis for failed total knee arthroplasty: case series

Michael Ransone et al. Arthroplast Today. .

Abstract

Knee arthrodesis is an option in the setting of failed total knee arthroplasty. Dual-plate fixation is a described technique to obtain knee fusion in this scenario. Literature on the complications of knee arthrodesis with dual-plate constructs is limited. We present 3 cases who underwent dual-plate knee arthrodesis complicated by peri-implant femur fracture.

Keywords: Complication; Failed TKA; Fracture; Knee arthrodesis; Knee fusion.

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Figures

Figure 1
Figure 1
Prearthrodesis radiographs. Anteroposterior (a) and lateral (b) radiographs showing extensive articular surface erosion and bone loss with varus deformity.
Figure 2
Figure 2
Postarthrodesis radiographs. Anteroposterior (a) and lateral (b) radiographs after dual-plate knee fusion using 12-hole and 14-hole plates medially.
Figure 3
Figure 3
Injury radiographs. Anteroposterior (a) and lateral (b) radiographs after a ground-level fall with peri-implant distal femur fracture.
Figure 4
Figure 4
Postoperative IMN radiographs. Anteroposterior (a) and lateral (b) radiographs after undergoing intramedullary fixation of peri-implant fracture.
Figure 5
Figure 5
Four-month postoperative radiographs. Anteroposterior (a) and lateral (b) radiographs 4 months postoperative showing interval callus bridging and bony consolidation at previous per-implant fracture site.
Figure 6
Figure 6
Prearthrodesis radiographs. PCA (a), anteroposterior (b), and lateral (c) radiographs showing valgus deformity and joint space narrowing after having recurrent MSSA septic knee arthritis.
Figure 7
Figure 7
Postarticulating spacer radiographs. Anteroposterior (a) and lateral (b) radiographs after stage 1 articulating antibiotic spacer.
Figure 8
Figure 8
Postarthrodesis radiographs. Anteroposterior (a) and lateral (b) postoperative radiographs after dual-plate knee fusion with 10-hole and 12-hole large fragment plates.
Figure 9
Figure 9
Injury radiographs. Anteroposterior (a) and lateral (b) radiographs showing distal femoral peri-implant fracture aftering leg struck the ground while transfering.
Figure 10
Figure 10
Postoperative revision plating and IMN radiographs. Anteroposterior (a) and lateral (b) radiographs after revision of the lateral plate to a 22-hole large fragment plate with additional intramedullary nail fixation.
Figure 11
Figure 11
Hardware failure from chronic knee and peri-implant fracture nonunions. Anteroposterior (a) and lateral (b) radiographs showing peri-implant fracture nonunion and subsequent lateral plate failure.
Figure 12
Figure 12
Postoperative revision IMN and bone grafting radiographs. PCA (a), anteroposterior (b), and lateral (c) radiographs after revision IMN and hardware removal. 13 × 700 mm nail was utilized. Retained broken hardware is noted at the medial aspect of the distal femur.
Figure 13
Figure 13
Primary TKA radiographs. Anteroposterior (a) and lateral (b) immediate postoperative radiographs of TKA performed at outside facility.
Figure 14
Figure 14
Postarticulating spacer radiographs. Anteroposterior (a) and lateral (b) radiographs after stage 1 articulating antibiotic spacer.
Figure 15
Figure 15
Post-reimplant radiographs. Anteroposterior (a) and lateral (b) radiographs after stage 2 revision TKA.
Figure 16
Figure 16
Postarthrodesis radiographs. Anteroposterior (a) and lateral (b) postoperative radiographs after dual-plate knee fusion with 12-hole and 14-hole large fragment plates.
Figure 17
Figure 17
Injury radiographs. Anteroposterior (a) and lateral (b) radiographs showing peri-implant femur fracture.
Figure 18
Figure 18
Postoperative revision ORIF radiographs. PCA radiograph after revision of the lateral plate to a 22-hole large fragment plate. Stable ipsilateral antibiotic hip spacer is also seen.
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References

    1. Conway J.D., Mont M.A., Bezwada H.P. Arthrodesis of the knee. J Bone Joint Surg Am. 2004;86(4):835. - PubMed
    1. MacDonald J.H., Agarwal S., Lorei M.P., Johanson N.A., Freiberg A.A. Knee arthrodesis. J Am Acad Orthop Surg. 2006;14(3):154. - PubMed
    1. Makhdom A.M., Fragomen A., Rozbruch R.S. Knee arthrodesis after failed total knee arthroplasty. J Bone Joint Surg Am. 2019;101(7):650. - PubMed
    1. Fehring K.A., Abdel M.P., Ollivier M., Mabry T.M., Hanssen A.D. Repeat two-stage exchange arthroplasty for periprosthetic knee infection is dependent on host grade. J Bone Joint Surg Am. 2017;99(1):19. - PubMed
    1. Wu C.H., Gray C.F., Lee G.C. Arthrodesis should be strongly considered after failed two-stage reimplantation TKA. Clin Orthop Relat Res. 2014;472(11):3295. - PMC - PubMed

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