title: Intraoperative fracture during staged total knee reimplantation in the treatment of periprosthetic infection.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Adam A
authors.initials: AA
authors.lastname: Sassoon
authors.affiliation: Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Nathaniel J
authors.initials: NJ
authors.lastname: Nelms
authors.affiliation: Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Trousdale
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000601:surgery*; D017102:Fracture Healing; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000175:diagnosis*; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012086:Reoperation; D012092:Replantation; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000150:complications / Q000601:surgery*
keywords: fracture; infection; knee; reimplantation