Is there an association between distal femoral morphology and periprosthetic femoral fracture risk after Posterior-Stabilized Total Knee Arthroplasty?

Halil Karaca, Ahmet Selami Kaya, Emre Kurt, Kursad Aytekin, Mustafa Cıtak

Abstract read

In one paragraph

Article in International orthopaedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Halil KaracaDepartment of Orthopaedics and Traumatology, Arhavi State Hospital, Arhavi, Turkey.

Ahmet Selami KayaDepartment of Orthopaedics and Traumatology, Giresun University, Giresun, Turkey.

Emre KurtDepartment of Orthopaedics and Traumatology, Sinop State Hospital, Sinop, Turkey.

Kursad AytekinDepartment of Orthopaedics and Traumatology, Giresun University, Giresun, Turkey.

Mustafa CıtakDepartment of Orthopaedic Surgery, ENDO-Klinik, Hamburg, Germany. mcitak@gmx.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study aims to determine whether distal femoral morphology (DFM) constitutes a risk factor for periprosthetic femoral fractures (PPFs) in a cohort of patients who underwent posterior-stabilized total knee arthroplasty (PS-TKA). MATERIALS AND

methodsRetrospective study of patients who had undergone primary PS-TKA, with a follow-up of minimum two years. Citak's ratio was calculated, and patients were classified according to DFM. Univariate and multivariate statistical analysis was performed to identify PPFs risk factors. ROC analysis was performed to evaluate the ability of DFM to distinguish patients at risk for PPFs.

resultsA total of 2452 patients 1644 female, 808 male were included in the analysis. The mean age of the participants was 70.2 years (SD = 6.4). PPFs were detected in 33 patients (1.35%). According to the Citak classification, patients were categorized as Group A (4/33, 12.1%), Group B (8/33, 24.2%), and Group C (21/33, 63.7%). DFM was significantly related to the PPFs rate (p = 0.001). The ROC curve analysis yielded an Area Under the Curve (AUC) of 0.669 (CI 95% 0.580-0.758) for the DFM.

conclusionsPreoperative evaluation of distal femoral morphology and management of osteoporosis may reduce the risk of fractures after PS-TKA.

Indexed as

Arthroplasty, Replacement, KneeFemoral FracturesFemurPeriprosthetic FracturesAgedAged, 80 and overFemaleFollow-Up StudiesHumansKnee ProsthesisMaleMiddle AgedRetrospective StudiesRisk FactorsROC CurveArthroplastyClassificationDistal femur morphologyKneePeriprosthetic fracture

Identifiers

PMID41699317

DOI10.1007/s00264-026-06756-9

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

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.