title: [Fractures of the knee joint in the elderly: osteosynthesis versus joint replacement].
abstract: BACKGROUND
  The aim of open reduction and internal fixation (ORIF) of fractures around the knee joint is the exact anatomic reconstruction of joint surfaces in order to achieve an early and load stable bone situation. Primary endoprosthetics as the initial treatment can represent an alternative treatment option for a closely selected number of geriatric patients.
  
  
  OBJECTIVE
  The chances and risks of primary endoprosthetics in comparison to ORIF as the gold standard for initial treatment of fractures close to the knee joint in the elderly are presented
  
  
  METHODS
  A selective search of the literature was carried out in consideration of national recommendations and own experience gained as head of a center for geriatric traumatology.
  
  
  RESULTS
  If the soft tissue coverage is not damaged by the injury, primary endoprosthetics can offer advantages compared to ORIF when a load stable joint is indispensable due to poor compliance, pre-existing arthritis and advanced age.
  
  
  CONCLUSIONS
  The risk of postoperative loss of correction is minimized by the prosthesis but the revision possibilities are very limited due to voluminous prostheses with a high degree of coupling. The indications for primary prosthesis implantation for acute treatment of fractures close to the knee should therefore be closely controlled because this should be the first and last intervention for fracture treatment in geriatric patients.
authors.affiliation: Orthopädische Klinik, Centre Hospitalier de Luxembourg, 78 rue d'Eich, 1460, Luxembourg, Luxembourg, dietrichpape@yahoo.de.
authors.forename: D
authors.initials: D
authors.lastname: Pape
authors.forename: A
authors.initials: A
authors.lastname: Hoffmann
authors.forename: T
authors.initials: T
authors.lastname: Gerich
authors.forename: M
authors.initials: M
authors.lastname: Van der Kerkhofe
authors.forename: M
authors.initials: M
authors.lastname: Weber
authors.forename: H-C
authors.initials: HC
authors.lastname: Pape
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005260:Female; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D007718:Knee Injuries / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology* / Q000601:surgery*; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome