Orlando Health Orthopedic Institute, Orlando, FL.
J Orthop Trauma. 2019 Sep;33 Suppl 6:S33-S35. doi: 10.1097/BOT.0000000000001566.
With increasing incidence of total knee arthroplasty (TKA), a concurrent rise in periprosthetic fractures is also expected. Although many periprosthetic fractures about a TKA can be fixed through locked plating, retrograde intramedullary nailing, or both, some fracture patterns combined with poor bone stock and/or osteolysis can offer a loose femoral component requiring TKA revision. TKA revision in the setting of periprosthetic fracture can be challenging and, often, nearly impossible as fractures that extend proximally may not be amenable to standard revision components. Distal femoral replacement may offer a more efficient, facile approach to treating periprosthetic fractures about a loose TKA component. Here, the role of distal femoral replacement is reviewed, offering indications, salient technical points, and tips to avoid pitfalls while allowing for immediate, reliable weight bearing in this challenging patient population.
随着全膝关节置换术（TKA）发病率的增加，预计也会出现更多的假体周围骨折。虽然许多 TKA 周围的骨折可以通过锁定钢板固定、逆行髓内钉固定或两者结合来固定，但一些骨折模式加上骨量差和/或骨溶解，可能会导致松动的股骨部件需要进行 TKA 翻修。TKA 翻修治疗假体周围骨折具有挑战性，而且往往几乎不可能，因为近端延伸的骨折可能不适用于标准的翻修部件。股骨远端置换术可能为治疗松动 TKA 组件周围的假体周围骨折提供更有效、更简便的方法。在这里，回顾了股骨远端置换术的作用，提供了适应证、突出的技术要点和避免陷阱的技巧，同时允许在这个具有挑战性的患者群体中立即、可靠地负重。
