ArticleBMC musculoskeletal disorders2018
Periprosthetic tibial fractures in total knee arthroplasty - an outcome analysis of a challenging and underreported surgical issue.
Article in BMC musculoskeletal disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Periprosthetic Fractures After Total Knee Arthroplasty-A Two-Center Study and Systematic Review of the Literature.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Surgical treatment of intra-articular distal radius fractures with the assistance of three-dimensional printing technique.Medicine · 2020Trial
- Minimally invasive posterior plate osteosynthesis of a periprosthetic distal tibia shaft fracture: case report and review of literature.International journal of surgery case reports · 2026Article
- Should We Worry About the Inter-Implant Gap in the Tibia? A Finite Element Analysis of Revision TKA and Distal Plating.Medicina (Kaunas, Lithuania) · 2026Article
- Three-Dimensional Printing in Hand Surgery: What Is New? A Systematic Review.Journal of personalized medicine · 2025Review
- Combining Plate and Ilizarov Fixation for Tibial Fracture in a 95-Year-Old Woman: A Case Report.The American journal of case reports · 2025Article
- Periprosthetic fractures of the tibial shaft following long-stemmed total knee arthroplasty: A case report.World journal of orthopedics · 2025Article
- Managing periprosthetic tibia fractures: International perspectives.OTA international : the open access journal of orthopaedic trauma · 2023Review
- Combination-type periprosthetic tibial fracture: Felix type (II+IV)A.BMJ case reports · 2023Article
- Clinical Applications of Three-Dimensional Printing in Upper Extremity Surgery: A Systematic Review.Journal of personalized medicine · 2023Review
- Outcome of Two-Stage Revision Total Hip and Knee Arthroplasty as a Salvage Procedure for Deep Infection of Peri-Articular Fracture Fixation: Propensity Score-Matched Study.The archives of bone and joint surgery · 2022Article
- Periprosthetic tibial fracture after total knee arthroplasty with popliteal artery injury-A case report.Trauma case reports · 2020Article
- Intraoperative tibial plateau fracture during bone preparation in a cruciate retaining primary total knee arthroplasty.BMJ case reports · 2020Article
- Ilizarov external fixation for a periprosthetic tibial fracture in severe osteoporosis: a case report.BMC musculoskeletal disorders · 2020Article
- Circadian rhythm disruption is associated with an increased risk of sarcopenia: a nationwide population-based study in Korea.Scientific reports · 2019Article
- Clinical feasibility and application value of computer virtual reduction combined with 3D printing technique in complex acetabular fractures.Experimental and therapeutic medicine · 2019Article
- Surgical outcomes of subtypes of periprosthetic tibia fractures after total knee arthroplasty.Journal of orthopaedicsArticle
- Surgical outcomes of periprosthetic distal femur fractures after total knee arthroplasty classified by Su et al. system.Journal of orthopaedicsArticle
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeriprosthetic fractures after total knee arthroplasty (TKA) are an increasing problem and challenging to treat. The tibial side is commonly less affected than the femoral side wherefore few studies and case reports are available. The aim of this study was to analyze the outcome of periprosthetic tibial fractures and compare our data with current literature.
methodsAll periprosthetic tibial TKA fractures that were treated at our Level 1 Trauma Center between 2011 and 2015 were included and analyzed consecutively. The Felix classification was used to assess the fracture type and evaluation included the radiological and clinical outcome (Knee Society Score/KSS, Oxford Knee Score/OKS).
resultsFrom a total of 50 periprosthetic TKA fractures, 9 cases (7 female, 2 male; 2 cruciate retaining, 7 constrained TKAs) involving the tibial side were identified. The mean age in this group was 77 (65-85) years with a follow-up rate of 67% after a mean of 22 (0-36) months. The Felix classification showed type IB (n = 1), type IIB (n = 2), type IIIA (n = 4) and type IIIB (n = 2) and surgical intervention included ORIF (n = 6), revision arthroplasty (n = 1), arthrodesis (n = 1) and amputation (n = 1). The rate of adverse events and revision was 55.6% including impaired wound healing, infection and re-fracture respectively peri-implant fracture. Main revision surgery included soft tissue surgery, arthrodesis, amputation and re-osteosynthesis. The clinical outcome showed a mean OKS of 29 (19-39) points and a functional/knee KSS of 53 (40-70)/41 (17-72) points. Radiological analyses showed 4 cases of malalignment after reduction and plate fixation.
conclusionsPeriprosthetic tibial fractures predominantly affect elderly patients with a reduced bone quality and reveal a high complication rate. Careful operative planning with individual solutions respecting the individual patient condition is crucial. If ORIF with a plate is considered, restoration of the correct alignment and careful soft tissue management including minimal invasive procedures seem important factors for the postoperative outcome.
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