title: Administration of teriparatide treatment for a challenging case of nonunion of periprosthetic fracture after total knee arthroplasty.
abstract: BACKGROUND
  Management of a periprosthetic fracture after total knee arthroplasty is often challenging because it typically occurs in elderly patients, who often have osteoporotic bone with a high risk of delayed union and nonunion. Thus, administration of a medication that could effectively accelerate fracture healing to prevent a delayed union or nonunion should significantly improve treatment outcome and patient's quality of life.
  
  
  METHODS
  We report the case of a 74-year-old rheumatoid arthritis woman with nonunion of a periprosthetic fracture after total knee arthroplasty, in whom bone union could not be achieved even after she underwent internal fixation and bone grafting twice; however, successful bone fusion was achieved after simple once-weekly administration of teriparatide for 6 months.
  
  
  CONCLUSIONS
  Although we report only one patient, the present case may suggest the advantage of preventive administration of teriparatide in addition to surgical procedures for treating nonunion of a periprosthetic fracture after total knee arthroplasty.
authors.affiliation: Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada, Shinjuku, Tokyo, 162-0054, Japan, ochi@1998.jukuin.keio.ac.jp.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Ochi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Ikari
authors.forename: Akari
authors.initials: A
authors.lastname: Naomi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Momohara
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D005599:Fractures, Ununited / Q000188:drug therapy*; D006801:Humans; D007270:Injections, Intra-Articular; D057068:Periprosthetic Fractures / Q000188:drug therapy*; D011475:Prosthesis Failure / Q000009:adverse effects*; D019379:Teriparatide / Q000008:administration & dosage*
chemical_list: D050071:Bone Density Conservation Agents; D019379:Teriparatide