Abstract
Several factors are conspiring to cause a dramatic increase in the incidence of periprosthetic
fractures. First, the incidence of arthroplasty is increasing as the population ages.
Second, arthroplasty is being performed in younger, more active patients, who live
longer after their arthroplasty and are more likely to have subsequent trauma to their
previously operated limb. Third, following lower extremity surgery, disuse osteopenia
of the limb often occurs, increasing the risk of subsequent fracture in that same
limb. This increased risk of later fracture is further aggravated by the implant placed
at the previous surgery, which often functions as a mechanical stress riser. Careful
attention to detail during knee arthroplasty or during fracture repair in which fixation
is placed close to the knee is beneficial for minimizing the risk of subsequent periprosthetic
fracture. Intraoperative vigilance, judicious use of force when inserting implants,
and meticulous technical execution of the procedure may all reduce fracture complications
postoperatively. This article reviews the prevalence of periprosthetic fractures about
knee arthroplasties and fracture fixation constructs, and also provides a description
of common recommendations intended to reduce the risk of periprosthetic fracture.
Keywords
periprosthetic fracture - distal femur fracture - knee arthroplasty
