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Periprosthetic Fractures Following Total Knee Arthroplasty

Periprosthetic fractures

A serious complication following a total knee arthroplasty (TKA) is a periprosthetic fracture. This involves the distal femur, proximal tibia or the patella, occurring more often in the supracondylar area of the distal femur.

Periprosthetic Fractures

A periprosthetic fracture is a broken bone that occurs around the components of a total knee replacement and usually requires a revision surgery. The femur is the most common fracture site.

Periprosthetic fractures tend to be more challenging to treat due to factors such as:

  • Quality of remaining bone
  • Type and location of the fracture
  • Pre-existing implant and bone cement
  • Whether the implant is loose

Because most TKA patients tend to be elderly, the risk of a periprosthetic fracture is higher.

What is a supracondylar fracture?

The medical definition of supracondylar is “relating to the area above the condyle (a round part at the end of a bone where it fits into another bone).”

Treatment of Periprosthetic Fractures

Surgical treatment is the current standard treatment for distal femoral fractures; however, improved results are being obtained with newer plate designs and techniques, two of which are:

  • Specially designed periarticular plates to better fit the shape of the distal femur so that less or no contouring of the plate is required.
  • Fixed-angle screw plates (Less Invasive Stabilization System – LISS) that allow surgeons to place multiple screws to avoid fracture lines in comminuted fractures, while decreasing the chance of loss of reduction from settling of the screws.

DePuy Synthes VA-LCP Curved Condylar Plate Failure

The VA-LCP Curved Condylar Plate, manufactured by DePuy Synthes, is part of the VA-LCP Periarticular Plating System that merges variable angle locking screw technology with conventional plating techniques. (LCP stands for locking compression plate.)

However, in a study presented at the March 2017 Orthopaedic Research Society annual conference, DePuy Synthes acknowledged a consistent pattern of plate failure through the combination hole at the level of comminution with the use of the Synthes VA-LCP Curved Condylar Plate for the management of AO type 33-A.3.3 fractures.

According to the study, “Our study is the first to investigate the biomechanical effects of screw-hole filling on construct fatigue life in the surgical management of distal femur fractures, and the results encourage further research on the biomechanical properties of different plate designs.”

Another study published in the January 2016 issue of Journal of Orthopaedic Trauma concluded: “Early mechanical failure with the VA distal femoral locking plate is higher than traditional locking plates (LCP and LISS) for OTA/AO 33-C fractures. … We caution practicing surgeons against the use of this plate for metaphyseal fragmented distal femur fractures.”

Questions? Our knowledgeable staff is available at (877) 284-6600.

What is the AO/OTA classification?

This is the current universally accepted classification for distal femur fractures. It divides the extra-articular type A fractures into three further groups and nine sub-groups.

According to the AO/OTA classification, the distal femur fractures are defined as those occurring within a length of bone, equivalent to the maximum condylar width, from the articular surface of distal femur.

Legal Assistance from Experienced Joint Replacement Attorneys

Defective femur bone implants cause severe pain to the patient, rendering him or her unable to walk. Patients suffer additional costs for hospitalization, medication, rehabilitation, home healthcare and lost wages.

Defective joint replacement lawsuits are complicated. You need experienced attorneys who know how to navigate the system, the ins-and-outs of medical lawsuits and joint replacement litigation. The attorneys at Nash & Franciskato are highly experienced and have a long track record of successfully litigating orthopedic cases.

If you are experiencing periprosthetic fractures of the femur after total knee arthroplasty, contact us today for a free, no-obligation case evaluation.

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