title: Custom intramedullary intercalating device for treatment of supracondylar fracture between constrained total knee arthroplasty and well-fixed total hip arthroplasty.
abstract: Management of periprosthetic fractures between ipsilateral total knee arthroplasty (TKA) and total hip arthroplasty (THA) is difficult, and is further complicated in the setting of poor femoral bone stock. We present a case of supracondylar fracture between THA and long-stemmed TKA femoral components in a patient with rheumatoid arthritis, deficient metaphyseal bone stock, and recurrent fractures. A long custom intramedullary intercalating component was devised to link the well-fixed existing THA stem to a revision distal femoral component. The resulting construct was stable and allowed for full weight-bearing ambulation, representing a useful treatment option in the management of periprosthetic fractures between revision TKA and well-fixed THA.
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 22710, United States. Electronic address: erik.newman@dm.duke.edu.
authors.forename: Erik T
authors.initials: ET
authors.lastname: Newman
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 22710, United States.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Hug
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 22710, United States.
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Wellman
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 22710, United States.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Bolognesi
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 22710, United States.
authors.forename: Scott S
authors.initials: SS
authors.lastname: Kelley
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D057068:Periprosthetic Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D012008:Recurrence