Intraoperative Fracture During Staged Total Knee Reimplantation in the Treatment of Periprosthetic Infection.

Journal of Arthroplasty

PubMedID: 24560463

Sassoon AA, Nelms NJ, Trousdale RT. Intraoperative Fracture During Staged Total Knee Reimplantation in the Treatment of Periprosthetic Infection. J Arthroplasty. 2014;29(7):1435-8.
Bone stock during knee reimplantation for infection is compromised and may contribute to intraoperative fracture. This study aims to describe the prevalence of said fractures. A retrospective review was performed of patients who underwent a staged TKA reimplantation for a periprosthetic infection. Patients who sustained an intraoperative fracture were analyzed. The fracture timing, location, and treatment were recorded. Fracture healing, component stability, and need for re-revision were noted. Between 1990 and 2010, 894 reimplantations were performed. Twenty-three fractures occurred in 21 patients (2.3%) with mean follow-up of 56 months (range: 4-122). Thirteen fractures occurred in femora, 7 in tibiae, and 3 in patellae. Four occurred during resection, while 19 occurred during reimplantation. Observation and wires/cables were the most common treatments utilized. At final follow-up, 91% of fractures demonstrated union and 75% of patients demonstrated stable components. Eight patients (38%) required a revision, the majority of which were performed for re-infection.