Evidence map›Paper›PMID 41317180›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

Outcomes of locked plating and retrograde intramedullary nailing for periprosthetic distal femur fractures after TKA.

Mark Wu, Brett Bukowski, Joel Hickman, Daniel Berry, William Cross, Stephen Sems, Matthew Abdel

Erratum issuedAbstract readComparative Study
PubMed Publisher
In one paragraph

Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Mark WuMayo Clinic, Rochester, USA.
Brett BukowskiMayo Clinic, Rochester, USA.
Joel HickmanMayo Clinic, Rochester, USA.
Daniel BerryMayo Clinic, Rochester, USA.
William CrossMayo Clinic, Rochester, USA.
Stephen SemsMayo Clinic, Rochester, USA.
Matthew AbdelMayo Clinic, Rochester, USA. abdel.matthew@mayo.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWe investigated outcomes of patients treated with either locked plating or retrograde intramedullary nailing (IMN) at a single institution and compared outcomes of retrograde IMN to locked plating for periprosthetic distal femur fractures.

methodsWe reviewed 241 subjects with distal femur fractures around total knee arthroplasty (TKA) treated with locked plating (197) or retrograde IMN (44). Mean age was 77 years, 78% were female, and mean BMI was 32 kg/m

resultsOverall nonunion rate was 10% and 5-year survivorship free of any revision was 81%, with the most common reasons being nonunion (49%), infection (19%), and aseptic TKA loosening (11%). Patients with prior TKA infection (HR 3; p = 0.02), revision TKA (HR 2; p = 0.03), Su III fractures (HR 2.5; p = 0.04) were at increased risk of revision. There was a trend toward higher non-union rate in the locked plating group (11% vs. 2%; p = 0.07). Those with locked plating had higher rates of osteoporosis (70% vs. 52%; p = 0.02), prior revision TKA (16% vs. 2%; p = 0.02), and Su Type III fractures (36% vs.16%, p = 0.047). Five-year survivorship free of any revision for locked plating and retrograde IMN were 80% and 84%, respectively, with no significant difference in revision, reoperation, or non-operative complications.

conclusionsBoth locked plating and retrograde IMN are viable fixation options for periprosthetic distal femur fractures after TKA. Those treated with locked plating had higher rates of osteoporosis, prior revision TKA, and more distal fractures, but did not demonstrate a significant increased risk for reoperation or revision. LEVEL OF EVIDENCE: Level III, Retrospective comparative cohort study.

Indexed as

Arthroplasty, Replacement, KneeBone PlatesFemoral FracturesFracture Fixation, IntramedullaryPeriprosthetic FracturesAgedAged, 80 and overBone NailsFemaleFemoral Fractures, DistalFractures, UnunitedHumansMaleMiddle AgedReoperationRetrospective StudiesFragility fractureMalunionNonunionRevision total knee arthroplasty (TKA)Trauma

Identifiers

PMID41317180

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.