title: [Importance of revision- and tumor-endoprosthetics in the treatment of periprosthetic fractures of the lower extremity].
abstract: Periprosthetic fractures of hip and knee prostheses are gaining clinical significance due to the increasing numbers of of primary arthroplasties. Additionally, these fractures are often associated with poor bone quality or present in patients after multiple revision procedures and concomitant excessive bone defects precluding those patients to be adequately treated by conventional osteosynthesis. Revision implants provide a wide range of options for the treatment of these fractures in order to achieve good clinical results. In the acetabular region cavitary defects associated with periprosthetic fractures can be treated by the use of megacups. Extensive segmental defects and pelvic discontinuity necessitate the use of cups with additional iliac support or even customized implants. Proximal femoral fractures can usually be fixed with modular stems and diaphyseal anchorage. Periprosthetic knee joint fractures can be treated with revision implants with modular sleeves or augment-combinations allowing sufficient bridging of bony defects. Functional reconstruction or refixation of the extensor mechanism is of crucial importance.
authors.affiliation: Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: P M
authors.initials: PM
authors.lastname: Prodinger
authors.affiliation: Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: N
authors.initials: N
authors.lastname: Harrasser
authors.affiliation: Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Suren
authors.affiliation: Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Pohlig
authors.affiliation: Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Mühlhofer
authors.affiliation: Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Schauwecker
authors.affiliation: Klinik und Poliklinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland. eisenhart@tum.de.
authors.forename: R
authors.initials: R
authors.lastname: von Eisenhart-Rothe
mesh_terms: D019317:Evidence-Based Medicine; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006620:Hip Fractures / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007720:Knee Prosthesis; D009369:Neoplasms / Q000601:surgery*; D057068:Periprosthetic Fractures / Q000175:diagnosis* / Q000601:surgery*; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D000072227:Shoulder Prosthesis; D016896:Treatment Outcome
keywords: Augmentation combinations; Hip; Knee; Mega-implants; Periprosthetic fracture