Treatment of periprosthetic tibial plateau fractures in unicompartmental knee arthroplasty: plates versus cannulated screws
Introduction Periprosthetic tibial plateau fractures (TPF) are rare but represent a serious complication in unicompartmental knee arthroplasty. The most common treatment for these fractures is osteosynthesis with cannulated screws or plates. The aim of this study was to evaluate two different treatm...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2013-02, Vol.133 (2), p.253-257 |
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| description | Introduction
Periprosthetic tibial plateau fractures (TPF) are rare but represent a serious complication in unicompartmental knee arthroplasty. The most common treatment for these fractures is osteosynthesis with cannulated screws or plates. The aim of this study was to evaluate two different treatment options for periprosthetic fractures. The hypothesis was that angle-stable plates show significantly higher fracture loads than fixation with cannulated screws.
Materials and methods
Twelve matched, paired fresh-frozen tibiae with periprosthetic TPF were used for this study. In Group A, osteosyntheses with cannulated screws were performed, whereas in Group B plates fixated the periprosthetic fracture. DEXA bone density measurement and standard X-rays (AP and lateral) were performed before loading the tibiae under standardised conditions with a maximum load of up to 10.0 kN. After the specimens had been loaded, fracture patterns and fracture loads were analysed and correlated with BMD, BMI, bodyweight (BW), age and size of the tibial implant.
Results
In the plate group all tibiae fracture occured with a median load of
F
max
= 2.64 (0.45–5.68) kN, whereas in the group with cannulated screws fractures occurred at a mean load of
F
max
= 1.50 (0.27–3.51) kN. The difference was statistically significant at
p
|
| doi_str_mv | 10.1007/s00402-012-1649-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1273780388</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1273780388</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-4da8f9df084310ce945fa3525f4c9ebba1421c3f0fe31410595037433fcbe02d3</originalsourceid><addsrcrecordid>eNp1kctu1jAQhS0Eon8LD8AGWWLTTcr4kovZoaq0lSqxKWvLccY0JXFSX1pVvDz-SaESEitr7O-c8cwh5B2DEwbQfowAEngFjFeskapqXpAdk0JWQrHmJdmBEk3VQc0OyGGMt1DATsFrcsAF41IqviM_rwOaNKNPdHF0xTCuYYnpBtNoaRr70Ux0nUxCk6kLxqYcMNLR0-xHu8yrCb_FhfrhEWkpb8JSBDE9ftqEkd5jiDlSa7zP-5uBRhvwIb4hr5yZIr59Oo_Ity9n16cX1dXX88vTz1eVFS1PlRxM59TgoJOCgUUla2dEzWsnrcK-N0xyZoUDh4JJBrWqQbRSCGd7BD6II3K8-ZbR7jLGpOcxWpwm43HJUTPeirYD0XUF_fAPervk4MvvNOcNU62qG1kotlG27CoGdHoN42zCo2ag98noLRldFq73yeimaN4_Oed-xuGv4k8UBeAbEMuT_47hufX_XX8BZ9CbbQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2261979564</pqid></control><display><type>article</type><title>Treatment of periprosthetic tibial plateau fractures in unicompartmental knee arthroplasty: plates versus cannulated screws</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Seeger, Joern Bengt ; Jaeger, S. ; Röhner, E. ; Dierkes, H. ; Wassilew, G. ; Clarius, M.</creator><creatorcontrib>Seeger, Joern Bengt ; Jaeger, S. ; Röhner, E. ; Dierkes, H. ; Wassilew, G. ; Clarius, M.</creatorcontrib><description>Introduction
Periprosthetic tibial plateau fractures (TPF) are rare but represent a serious complication in unicompartmental knee arthroplasty. The most common treatment for these fractures is osteosynthesis with cannulated screws or plates. The aim of this study was to evaluate two different treatment options for periprosthetic fractures. The hypothesis was that angle-stable plates show significantly higher fracture loads than fixation with cannulated screws.
Materials and methods
Twelve matched, paired fresh-frozen tibiae with periprosthetic TPF were used for this study. In Group A, osteosyntheses with cannulated screws were performed, whereas in Group B plates fixated the periprosthetic fracture. DEXA bone density measurement and standard X-rays (AP and lateral) were performed before loading the tibiae under standardised conditions with a maximum load of up to 10.0 kN. After the specimens had been loaded, fracture patterns and fracture loads were analysed and correlated with BMD, BMI, bodyweight (BW), age and size of the tibial implant.
Results
In the plate group all tibiae fracture occured with a median load of
F
max
= 2.64 (0.45–5.68) kN, whereas in the group with cannulated screws fractures occurred at a mean load of
F
max
= 1.50 (0.27–3.51) kN. The difference was statistically significant at
p
< 0.05.
Discussion
Angle-stable plates showed significantly higher fracture loads than fixation with cannulated screws. Cannulated screws show a reduced stability of the tibial plateau. Therefore in periprosthetic TPF, osteosyntheses with angle-stable plates should be recommended instead of cannulated screws.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-012-1649-6</identifier><identifier>PMID: 23124492</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee - adverse effects ; Biomechanical Phenomena ; Bone Plates ; Bone Screws ; Cadaver ; Fracture Fixation, Internal - instrumentation ; Fractures ; Humans ; Joint surgery ; Knee ; Knee Arthroplasty ; Load ; Medicine ; Medicine & Public Health ; Middle Aged ; Orthopedics ; Periprosthetic Fractures - etiology ; Periprosthetic Fractures - physiopathology ; Periprosthetic Fractures - surgery ; Tibia - injuries ; Tibia - surgery ; Tibial Fractures - etiology ; Tibial Fractures - physiopathology ; Tibial Fractures - surgery</subject><ispartof>Archives of orthopaedic and trauma surgery, 2013-02, Vol.133 (2), p.253-257</ispartof><rights>Springer-Verlag Berlin Heidelberg 2012</rights><rights>Archives of Orthopaedic and Trauma Surgery is a copyright of Springer, (2012). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-4da8f9df084310ce945fa3525f4c9ebba1421c3f0fe31410595037433fcbe02d3</citedby><cites>FETCH-LOGICAL-c372t-4da8f9df084310ce945fa3525f4c9ebba1421c3f0fe31410595037433fcbe02d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-012-1649-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-012-1649-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27902,27903,41466,42535,51296</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23124492$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Seeger, Joern Bengt</creatorcontrib><creatorcontrib>Jaeger, S.</creatorcontrib><creatorcontrib>Röhner, E.</creatorcontrib><creatorcontrib>Dierkes, H.</creatorcontrib><creatorcontrib>Wassilew, G.</creatorcontrib><creatorcontrib>Clarius, M.</creatorcontrib><title>Treatment of periprosthetic tibial plateau fractures in unicompartmental knee arthroplasty: plates versus cannulated screws</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
Periprosthetic tibial plateau fractures (TPF) are rare but represent a serious complication in unicompartmental knee arthroplasty. The most common treatment for these fractures is osteosynthesis with cannulated screws or plates. The aim of this study was to evaluate two different treatment options for periprosthetic fractures. The hypothesis was that angle-stable plates show significantly higher fracture loads than fixation with cannulated screws.
Materials and methods
Twelve matched, paired fresh-frozen tibiae with periprosthetic TPF were used for this study. In Group A, osteosyntheses with cannulated screws were performed, whereas in Group B plates fixated the periprosthetic fracture. DEXA bone density measurement and standard X-rays (AP and lateral) were performed before loading the tibiae under standardised conditions with a maximum load of up to 10.0 kN. After the specimens had been loaded, fracture patterns and fracture loads were analysed and correlated with BMD, BMI, bodyweight (BW), age and size of the tibial implant.
Results
In the plate group all tibiae fracture occured with a median load of
F
max
= 2.64 (0.45–5.68) kN, whereas in the group with cannulated screws fractures occurred at a mean load of
F
max
= 1.50 (0.27–3.51) kN. The difference was statistically significant at
p
< 0.05.
Discussion
Angle-stable plates showed significantly higher fracture loads than fixation with cannulated screws. Cannulated screws show a reduced stability of the tibial plateau. Therefore in periprosthetic TPF, osteosyntheses with angle-stable plates should be recommended instead of cannulated screws.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Biomechanical Phenomena</subject><subject>Bone Plates</subject><subject>Bone Screws</subject><subject>Cadaver</subject><subject>Fracture Fixation, Internal - instrumentation</subject><subject>Fractures</subject><subject>Humans</subject><subject>Joint surgery</subject><subject>Knee</subject><subject>Knee Arthroplasty</subject><subject>Load</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Periprosthetic Fractures - etiology</subject><subject>Periprosthetic Fractures - physiopathology</subject><subject>Periprosthetic Fractures - surgery</subject><subject>Tibia - injuries</subject><subject>Tibia - surgery</subject><subject>Tibial Fractures - etiology</subject><subject>Tibial Fractures - physiopathology</subject><subject>Tibial Fractures - surgery</subject><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kctu1jAQhS0Eon8LD8AGWWLTTcr4kovZoaq0lSqxKWvLccY0JXFSX1pVvDz-SaESEitr7O-c8cwh5B2DEwbQfowAEngFjFeskapqXpAdk0JWQrHmJdmBEk3VQc0OyGGMt1DATsFrcsAF41IqviM_rwOaNKNPdHF0xTCuYYnpBtNoaRr70Ux0nUxCk6kLxqYcMNLR0-xHu8yrCb_FhfrhEWkpb8JSBDE9ftqEkd5jiDlSa7zP-5uBRhvwIb4hr5yZIr59Oo_Ity9n16cX1dXX88vTz1eVFS1PlRxM59TgoJOCgUUla2dEzWsnrcK-N0xyZoUDh4JJBrWqQbRSCGd7BD6II3K8-ZbR7jLGpOcxWpwm43HJUTPeirYD0XUF_fAPervk4MvvNOcNU62qG1kotlG27CoGdHoN42zCo2ag98noLRldFq73yeimaN4_Oed-xuGv4k8UBeAbEMuT_47hufX_XX8BZ9CbbQ</recordid><startdate>20130201</startdate><enddate>20130201</enddate><creator>Seeger, Joern Bengt</creator><creator>Jaeger, S.</creator><creator>Röhner, E.</creator><creator>Dierkes, H.</creator><creator>Wassilew, G.</creator><creator>Clarius, M.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20130201</creationdate><title>Treatment of periprosthetic tibial plateau fractures in unicompartmental knee arthroplasty: plates versus cannulated screws</title><author>Seeger, Joern Bengt ; Jaeger, S. ; Röhner, E. ; Dierkes, H. ; Wassilew, G. ; Clarius, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-4da8f9df084310ce945fa3525f4c9ebba1421c3f0fe31410595037433fcbe02d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Biomechanical Phenomena</topic><topic>Bone Plates</topic><topic>Bone Screws</topic><topic>Cadaver</topic><topic>Fracture Fixation, Internal - instrumentation</topic><topic>Fractures</topic><topic>Humans</topic><topic>Joint surgery</topic><topic>Knee</topic><topic>Knee Arthroplasty</topic><topic>Load</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Periprosthetic Fractures - etiology</topic><topic>Periprosthetic Fractures - physiopathology</topic><topic>Periprosthetic Fractures - surgery</topic><topic>Tibia - injuries</topic><topic>Tibia - surgery</topic><topic>Tibial Fractures - etiology</topic><topic>Tibial Fractures - physiopathology</topic><topic>Tibial Fractures - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Seeger, Joern Bengt</creatorcontrib><creatorcontrib>Jaeger, S.</creatorcontrib><creatorcontrib>Röhner, E.</creatorcontrib><creatorcontrib>Dierkes, H.</creatorcontrib><creatorcontrib>Wassilew, G.</creatorcontrib><creatorcontrib>Clarius, M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Seeger, Joern Bengt</au><au>Jaeger, S.</au><au>Röhner, E.</au><au>Dierkes, H.</au><au>Wassilew, G.</au><au>Clarius, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of periprosthetic tibial plateau fractures in unicompartmental knee arthroplasty: plates versus cannulated screws</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2013-02-01</date><risdate>2013</risdate><volume>133</volume><issue>2</issue><spage>253</spage><epage>257</epage><pages>253-257</pages><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
Periprosthetic tibial plateau fractures (TPF) are rare but represent a serious complication in unicompartmental knee arthroplasty. The most common treatment for these fractures is osteosynthesis with cannulated screws or plates. The aim of this study was to evaluate two different treatment options for periprosthetic fractures. The hypothesis was that angle-stable plates show significantly higher fracture loads than fixation with cannulated screws.
Materials and methods
Twelve matched, paired fresh-frozen tibiae with periprosthetic TPF were used for this study. In Group A, osteosyntheses with cannulated screws were performed, whereas in Group B plates fixated the periprosthetic fracture. DEXA bone density measurement and standard X-rays (AP and lateral) were performed before loading the tibiae under standardised conditions with a maximum load of up to 10.0 kN. After the specimens had been loaded, fracture patterns and fracture loads were analysed and correlated with BMD, BMI, bodyweight (BW), age and size of the tibial implant.
Results
In the plate group all tibiae fracture occured with a median load of
F
max
= 2.64 (0.45–5.68) kN, whereas in the group with cannulated screws fractures occurred at a mean load of
F
max
= 1.50 (0.27–3.51) kN. The difference was statistically significant at
p
< 0.05.
Discussion
Angle-stable plates showed significantly higher fracture loads than fixation with cannulated screws. Cannulated screws show a reduced stability of the tibial plateau. Therefore in periprosthetic TPF, osteosyntheses with angle-stable plates should be recommended instead of cannulated screws.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>23124492</pmid><doi>10.1007/s00402-012-1649-6</doi><tpages>5</tpages></addata></record> |
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| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Aged, 80 and over Arthroplasty, Replacement, Knee - adverse effects Biomechanical Phenomena Bone Plates Bone Screws Cadaver Fracture Fixation, Internal - instrumentation Fractures Humans Joint surgery Knee Knee Arthroplasty Load Medicine Medicine & Public Health Middle Aged Orthopedics Periprosthetic Fractures - etiology Periprosthetic Fractures - physiopathology Periprosthetic Fractures - surgery Tibia - injuries Tibia - surgery Tibial Fractures - etiology Tibial Fractures - physiopathology Tibial Fractures - surgery |
| title | Treatment of periprosthetic tibial plateau fractures in unicompartmental knee arthroplasty: plates versus cannulated screws |
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