(Fig 5-D.21) Periprosthetic Fracture

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📌 Femoral Periprosthetic Fractures

✅ Lewis and Rorabeck Classification:

• Type 1: Nondisplaced femoral fracture with intact prosthesis
• Type 2: Displaced femoral fracture with intact prosthesis
• Type 3: Displaced or nondisplaced fracture with loosening or failing of the prosthesis

 

✅ Risk Factors:

• Defects of the anterior femoral cortex from surgical notching
• Cystic lesions of degenerative or rheumatoid origin
• Osteolysis secondary to wear-related debris
  
  

 

✅ Supracondylar Fractures:

• Most frequently encountered fracture near a TKA (Total Knee Arthroplasty)
• Often, a devastating complication
• Classified and managed based on displacement and prosthesis stability
  
  

 

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📌 Tibial Periprosthetic Fractures

✅ Felix and Stuart Classification:

• Type 1: Fractures involve the tibial plateau
• Type 2: Fractures are adjacent to the tibial stem
• Type 3: Fractures are distal to the prosthesis
• Type 4: Fractures involve the tibial tubercle

 

✅ Occurrence and Management:

• Tibial periprosthetic fractures occur infrequently
• Classified and managed based on the anatomic location of the fracture and the stability of the prosthesis
  
  

 

References

• Semin Musculoskelet Radiol 2017;21:147–164
• RadioGraphics 2015; 35:1483–1501
• AJR 2014; 202:W76–W86

 

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#PeriprostheticFracture, #FemoralFracture, #TibialFracture, #Orthopedics, #Radiology, #SurgicalComplications, #LewisAndRorabeck, #FelixAndStuart, #TKA, #FractureManagement