Periprosthetic fracture of the knee Prof Dr KarlHeinz

Periprosthetic fracture of the knee Prof. Dr. Karl-Heinz Frosch University Medical Center Hamburg Germany

Periprosthetic fracture of the knee • 71 -year-old man • Bicycle accident • Only mild knee pain before trauma • What would you do? • Computed tomographic (CT) scan? • Puncture?

Periprosthetic fracture of the knee • 71 -year-old man • Bicycle accident • Only mild knee pain before trauma • Emergency? • External fixator? • Osteosynthesis? • Revision arthroplasty?

Periprosthetic fracture of the knee • 71 -year-old man • Bicycle accident • Only mild knee pain before trauma • Osteosynthesis the next day • No external fixator • Intraoperative femoral distractor • “Hook” behind the patella shield to correct retroversion

Periprosthetic fracture of the knee • 71 -year-old man • Bicycle accident • Only mild knee pain before trauma • Persisting pain after 6 months • CT scan showed pseudarthrosis • What would you do? Postoperative 6 months

Periprosthetic fracture of the knee • 71 -year-old man • Bicycle accident • Only mild knee pain before trauma • Persisting pain after 6 months • Aspirate: • 2492 leucocytes/µl • 8% granulocytes • And now? Postoperative 6 months

Periprosthetic fracture of the knee • 71 -year-old man • Bicycle accident • Only mild knee pain before trauma • Resection of pseudarthrosis from medial • Autogenous bone graft • Additional medial plate • Healing after 3 months