Locked plate versus retrograde intramedullary nail for periprosthetic femur fractures above total knee arthroplasty: a meta-analysis.
Locked plate (LP) and retrograde intramedullary nail (RIN) are the most commonly used treatment options for periprosthetic femur fracture above total knee arthroplasty (TKA). Controversy still exists regarding which is better. Therefore we performed a meta-analysis to compare their clinical results.



A comprehensive search was conducted through PubMed, EMBase and the Cochrane Collaboration Library. Six comparative studies (265 patients) were included for the meta-analysis.



No statistically significant differences were found between the LP group and RIN group in terms of six month union rate (OR, 1.19; 95 % CI, 0.52-2.69; P = 0.68), union time (WMD, 0.22; 95 % CI, -0.41 to 0.84; P = 0.50), operation time (WMD, 0.54; 95 % CI, -13.09 to 14.17; P = 0.94) or complication rate (OR, 0.79; 95 % CI, 0.22-2.91; P = 0.73). The LP fixation may have a relatively higher re-operation rate (OR, 5.17; 95 % CI, 1.02-26.27; P = 0.05) compared with RIN. The mean union time was 4.0 months in the LP group and 3.7 months in the RIN group.



This meta-analysis found no statistically significant difference in six month union rate, union time, operation time and complication rate between the LP group and RIN group. The RIN fixation may have a potential of lower re-operation rate compared with LP. The mean union time was 4.0 months in the LP group and 3.7 months in the RIN group.
Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Dongcheng District Shuaifuyuan NO. 1, Beijing, 100730, China.
Bo
B
Li
Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Dongcheng District Shuaifuyuan NO. 1, Beijing, 100730, China.
Peng
P
Gao
Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Dongcheng District Shuaifuyuan NO. 1, Beijing, 100730, China. qiugx@medmail.com.cn.
Guixing
G
Qiu
Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Dongcheng District Shuaifuyuan NO. 1, Beijing, 100730, China.
Tao
T
Li
D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001860:Bone Plates / Q000009:adverse effects; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D061646:Operative Time; D057068:Periprosthetic Fractures / Q000601:surgery*; D012086:Reoperation / Q000009:adverse effects*
Femur fracture; Intramedullary nail; LISS; Locked plate; Periprosthetic; Total knee arthroplasty