Canton Gianluca, Ratti Chiara, Fattori Roberto, Hoxhaj Bramin, Murena Luigi
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Acta Biomed. 2017 Jun 7;88(2S):118-128. doi: 10.23750/abm.v88i2-S.6522.
Periprosthetic knee fractures incidence is gradually raising due to aging of population and increasing of total knee arthroplasties. Management of this complication represents a challenge for the orthopaedic surgeon. Aim of the present study is to critically review the recent literature about epidemiology, risk factors, diagnosis, management and outcome of periprosthetic knee fractures.
A systematic search of Embase, Medline and Pubmed was performed by two reviewers who selected the eligible papers favoring studies published in the last ten years. Epidemiology, risk factors, diagnostic features, clinical management and outcome of different techniques were all reviewed.
52 studies including reviews, meta-analysis, clinical and biomechanical studies were selected.
Correct clinical management requires adequate diagnosis and evaluation of risk factors. Conservative treatment is rarely indicated. Locking plate fixation, intramedullary nailing and revision arthroplasty are all valuable treatment methods. Surgical technique should be chosen considering age and functional demand, comorbidities, fracture morphology and location, bone quality and stability of the implant. Given the correct indication all surgical treatment can lead to satisfactory clinical and radiographic results despite a relevant complication rate.
由于人口老龄化以及全膝关节置换术数量的增加，人工膝关节周围骨折的发生率正在逐渐上升。处理这一并发症对骨科医生而言是一项挑战。本研究的目的是对近期有关人工膝关节周围骨折的流行病学、危险因素、诊断、处理及预后的文献进行批判性综述。
两名研究者对Embase、Medline和Pubmed进行了系统检索，选择了近十年发表的符合条件的研究论文。对流行病学、危险因素、诊断特征、不同技术的临床处理及预后均进行了综述。
共筛选出52项研究，包括综述、荟萃分析、临床及生物力学研究。
正确的临床处理需要对危险因素进行充分的诊断和评估。很少采用保守治疗。锁定钢板固定、髓内钉固定及翻修关节成形术都是有价值的治疗方法。应根据年龄、功能需求、合并症、骨折形态及部位、骨质及植入物稳定性来选择手术技术。尽管并发症发生率较高，但在正确的适应证下，所有手术治疗均可取得满意的临床及影像学效果。
