Rothman Institute of Orthopedics at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.
J Arthroplasty. 2010 Aug;25(5):775-80. doi: 10.1016/j.arth.2009.05.024. Epub 2010 Feb 19.
Periprosthetic fractures after total knee arthroplasty present substantial challenge if associated with poor bone stock, fracture comminution, and loose or damaged components. Revision total knee arthroplasty with distal femoral arthroplasty is often necessary in these injuries. We reviewed 20 patients (22 knees) with a mean age of 69.5 years who underwent revision with distal femoral arthroplasty fracture. Patients were followed for an average of 58.6 months. At the latest follow-up, the mean Knee Society knee and functional score were 82.8 and 40, and the Short Form 36 mean physical functioning and mental functioning scores were 55.8 and 65.6, respectively. There were 10 postoperative complications with 5 patients requiring additional surgery. Distal femoral arthroplasty seems to be a viable option for complex periprosthetic femoral fractures after total knee arthroplasty. However, considering the relatively high rate of complications, this procedure should be reserved for patients where alternative treatments are not possible.
全膝关节置换术后的假体周围骨折，如果伴有骨量差、骨折粉碎、假体松动或损坏，将是一个巨大的挑战。在这些损伤中，常需要进行翻修全膝关节置换术和股骨远端置换术。我们回顾了 20 例（22 膝）平均年龄为 69.5 岁的患者，这些患者均接受了股骨远端置换术治疗骨折。患者平均随访 58.6 个月。在最近的随访中，膝关节学会膝关节和功能评分的平均值分别为 82.8 和 40，36 简短表格的平均身体功能和精神功能评分分别为 55.8 和 65.6。有 10 例术后并发症，5 例需要进一步手术。股骨远端置换术似乎是全膝关节置换术后复杂假体周围股骨骨折的一种可行选择。然而，考虑到较高的并发症发生率，该手术应保留给无法进行其他治疗的患者。
