Department of Orthopedic Surgery, Yeungnam University College of Medicine, 170 Hyeonchung-Ro Nam-Gu, Daegu, 42415, Republic of Korea.
Department of Orthopedic Surgery, Yeungnam University Medical Center, 170 Hyeonchung-Ro Nam-Gu, Daegu, 42415, Republic of Korea.
BMC Musculoskelet Disord. 2023 Jul 20;24(1):594. doi: 10.1186/s12891-023-06726-x.
The purpose of this study was to introduce the surgical technique using long locking plate and locking attachment plate (LAP) in patient with periprosthetic femoral fracture around ipsilateral stem after total knee arthroplasty (TKA). Moreover, we sought to investigate the outcomes of this fixation technique and to propose a new subtype in the existing classification of periprosthetic femoral fractures.
From January 2013 to January 2022, thirty-four consecutive periprosthetic femoral fractures around ipsilateral stem following TKA with minimum 1-year follow-up were enrolled in this study. Most cases were fixed with long-locking plate and LAP using the MIPO technique. For subgroup analysis, we classified patients with stemmed hip implant (group H) and stemmed knee implant (group K). Bone union, American Knee Society Score (AKSS) scale, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, the Western Ontario and McMaster Universities Osteoarthritis Index for pain and function, and range of motion were investigated.
The number of group H and K were 24 patients (70.6%) and 10 patients (29.4%), respectively. The mean age at operation was 71.5 years (range, 65‒85 years), and the mean follow-up period was 27.5 months (range, 12‒72 months). Bone union was confirmed radiographically in all patients, and the mean union time was 4.9 months (range, 3.5‒6 months). There were no significant differences in radiographic and clinical outcomes between the groups.
Long-locking plate combined with LAP showed favorable radiographic and clinical outcomes in patients with periprosthetic femoral fracture around ipsilateral stem after TKA.
Level IV, Retrospective Case Series.
本研究旨在介绍一种在全膝关节置换（TKA）后同侧柄周围假体股骨骨折患者中使用长锁定板和锁定接骨板（LAP）的手术技术。此外，我们试图探讨这种固定技术的结果，并在现有的假体股骨骨折分类中提出一个新的亚型。
自 2013 年 1 月至 2022 年 1 月，共纳入 34 例 TKA 后同侧柄周围假体股骨骨折患者，随访时间至少 1 年。大多数病例采用 MIPO 技术使用长锁定板和 LAP 固定。对于亚组分析，我们将患者分为带柄髋关节植入物（组 H）和带柄膝关节植入物（组 K）。我们研究了骨愈合、美国膝关节协会评分（AKSS）量表、膝关节损伤和骨关节炎关节置换评分、西安大略和麦克马斯特大学骨关节炎指数疼痛和功能、活动范围。
组 H 和 K 的患者分别为 24 例（70.6%）和 10 例（29.4%）。手术时的平均年龄为 71.5 岁（65-85 岁），平均随访时间为 27.5 个月（12-72 个月）。所有患者均经影像学证实骨愈合，平均愈合时间为 4.9 个月（3.5-6 个月）。两组之间的影像学和临床结果无显著差异。
在 TKA 后同侧柄周围假体股骨骨折患者中，长锁定板联合 LAP 可获得良好的影像学和临床结果。
IV 级，回顾性病例系列。
