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Meta-Analysis
. 2021 Jan 22;16(1):78.
doi: 10.1186/s13018-021-02222-x.

Locked compression plating versus retrograde intramedullary nailing in the treatment of periprosthetic supracondylar knee fractures: a systematic review and meta-analysis

Henry Magill  1 , Nikhil Ponugoti  2 , Amr Selim  3 , James Platt  4
Affiliations
Meta-Analysis

Locked compression plating versus retrograde intramedullary nailing in the treatment of periprosthetic supracondylar knee fractures: a systematic review and meta-analysis

Henry Magill et al. J Orthop Surg Res. .

Abstract

Background: Periprosthetic fractures of the distal femur above a total knee arthroplasty (TKA) have traditionally been managed by locking compression plating (LCP). This technique is technically demanding and is associated with high rates of non-union and revision. More recently, retrograde intramedullary nailing (RIMN) has been proposed as an acceptable alternative. This meta-analysis aims to evaluate clinical outcomes in patients with periprosthetic supracondylar femoral fractures who were treated with LCP and RIMN.

Methods: An up-to-date literature search was carried out using the pre-defined search strategy. All studies that met the inclusion criteria were assessed for methodological quality with the Cochrane's collaboration tool. Operative time, functional score, time-to-union, non-union rates and revision rates were all considered.

Conclusion: Ten studies with a total of 531 periprosthetic fractures were included. This meta-analysis has suggested that there is no significant difference in any of the outcome measures assessed. Further, more extensive literature is required on the subject to draw more robust conclusions.

Keywords: Fixation; Fracture; Periprosthetic; TKR; Trauma.

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Conflict of interest statement

The authors whose names are listed immediately below certify that they have no affiliations with or involvement in any organisation or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
The Preferred Reporting Items for Systematic reviews and Meta-analysis
Fig. 2
Fig. 2
A forest plot showing the comparison of operative time (min) between the two fixation methods. CI, confidence interval; IV, independent variable; M-H, Mantel-Haenszel; LCP, locking compression plate; RIMN, retrograde intramedullary nail
Fig. 3
Fig. 3
A forest plot showing the comparison of knee functional scores between the two fixation methods. CI, confidence interval; IV, independent variable; M-H, Mantel-Haenszel; LCP, locking compression plate; RIMN, retrograde intramedullary nail
Fig. 4
Fig. 4
A forest plot showing the comparison of time to union (months) between the two fixation methods. CI, confidence interval; IV, independent variable; M-H, Mantel-Haenszel; LCP, locking compression plate; RIMN, retrograde intramedullary nail
Fig. 5
Fig. 5
A forest plot showing the comparison of non-union rate between the two fixation methods. CI, confidence interval; IV, independent variable; M-H, Mantel-Haenszel; LCP, locking compression plate; RIMN, retrograde intramedullary nail
Fig. 6
Fig. 6
A forest plot showing the comparison of revision rate between the two fixation methods. CI, confidence interval; IV, independent variable; M-H, Mantel-Haenszel; LCP, locking compression plate; RIMN, retrograde intramedullary nail
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