Megaprosthetic reconstruction for periprosthetic or highly comminuted fractures of the hip and knee.

Abstract

OBJECTIVES:

To present the experience of a tertiary referral hospital in the management of a case series with hip or knee fractures by using modular megaprosthesis.

PATIENTS AND METHODS:

Seventeen consecutive patients with highly comminuted fractures of the knee (n = 2), periprosthetic fractures of knee (n = 10) or hip (n = 5) were included. Fractures were managed with modular megaprosthesis (including total hip in 2 cases). Postoperative complications like infection and instability and outcome measures like return to previous mobility and living were recorded.

RESULTS:

The mean age at time of surgery was 77 years (25-91), and mean follow-up was 44 months (13-98). We had no intra-operative complications. There were 3 deep periprosthetic infections, 1 hip and 2 knee. In the hip group, including total femur patients, we had 2 dislocations (2/7), both managed with closed reduction. No aseptic loosening was seen. 15/17 patients regained walking ability, and 16 were discharged to independent living. Nine patients have died at the time of follow-up.

CONCLUSIONS:

In these often old and physically compromised patients with highly comminuted fractures or complicated periprosthetic fractures, modular megaprosthesis could be a good surgical option. It can provide immediate stability and allow early mobilization.

• Authors: Fredrik Lundh, Arkan S Sayed-Noor, Otte Brosjö, Henrik Bauer
• Journal: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie (Eur J Orthop Surg Traumatol) Vol. 24 Issue 4 Pg. 553-7 (May 2014) ISSN: 1432-1068 [Electronic] France
• PMID: 23689913 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Arthroplasty, Replacement, Hip (adverse effects, methods)
• Arthroplasty, Replacement, Knee (adverse effects, methods)
• Female
• Follow-Up Studies
• Fractures, Comminuted (diagnostic imaging, surgery)
• Hip Fractures (diagnostic imaging, surgery)
• Hip Prosthesis
• Humans
• Knee Injuries (diagnostic imaging, surgery)
• Knee Prosthesis
• Male
• Middle Aged
• Prosthesis Failure
• Prosthesis Implantation (methods)
• Radiography
• Recovery of Function
• Retrospective Studies
• Treatment Outcome