Description
A retrospective case series study of patients (from January 2011 to August 2023) with a diagnosis of periprosthetic knee fracture and treated by prosthetic knee revision was performed. The decision to perform a prosthetic revision or a reduction and internal fixation of the fracture was made by a committee with the knee team and the trauma team of our hospital. The criterion we used was based on the remaining bone stock in the distal part of the femur and the degree of prosthetic loosening. In total, 20 patients were analyzed with a mean follow-up of 15.25 months (SD 18.27). A descriptive study of demographic, clinical and radiological factors, and a survival study were performed.
The sample consisted in 16 women and 4 men. The mean age at the time of surgery was 81.20 years (SD 11.72). 17 patients (85%) had Rorabeck type 2 fracture and 3 patients (15%) had Rorabeck type 3 fracture. Patients over 75 years restarted walking later and required more hospitalization time than younger patients. They also required more blood transfusions and had more surgical complications than younger patients. 35% of patients required surgical revision due to various complications, periprosthetic infection being the most frequent with 20%. Of all sample, 30% died,1 of them (5%) during hospitalization due to an ischemic stroke.
Periprosthetic knee fractures can be treated by prosthetic revision, presenting good results. Although, it is important to not forget that this type of fractures are usually found in elderly people with several comorbidities, so surgery sometimes is associated with a high incidence of complications and mortality.
