Total knee arthroplasty periprosthetic fracture - type II Lewis and Rorabeck Classification

Case contributed by Dr Domenico Nicoletti

Presentation

Fall down the stairs.

Patient Data

Age: 80 years
Gender: Female

RX right knee

Distal femur periprosthetic displaced fracture with component intact.

Rx right knee

Locked plating of a supracondylar distal femur fracture above a stable femoral component with two Kirschner wires inserted through the medial femoral condyle.

Case Discussion

These fractures occur above or around the femoral component of a total knee arthroplasty followed by the patella and tibia. Metabolic issues such as osteoporosis are known risk factors for the development of periprosthetic fractures. Surgical treatment is necessary. Reduction and fixation of these fractures is a complex work as a result of the preexisting implants that can obstruct reduction and placement of fixation devices. 

Lewis and Rorabeck classification of supracondylar periprosthetic fractures proximal to knee arthroplasty:

  • type I: undisplaced fracture, stable prosthesis
  • type II: displaced fracture, stable prosthesis
  • type III: isplaced or undisplaced fracture, unstable prosthesis

Radiographer: TSRM Fabio Imola

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