Periprosthetic supracondylar femoral fractures following knee arthroplasty: a biomechanical comparison of four methods of fixation

Purpose The aim of this study was to determine the biomechanical properties of four fixation options for periprosthetic supracondylar femoral fractures. Methods Fourth-generation composite femurs were implanted with a posterior-stabilizing femoral component of total knee arthroplasty. All femurs wer...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:International orthopaedics 2015-09, Vol.39 (9), p.1737-1742
Hauptverfasser: Mäkinen, Tatu J., Dhotar, Herman S., Fichman, Simcha G., Gunton, Matthew J., Woodside, Mitchell, Safir, Oleg, Backstein, David, Willett, Thomas L., Kuzyk, Paul R. T.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Purpose The aim of this study was to determine the biomechanical properties of four fixation options for periprosthetic supracondylar femoral fractures. Methods Fourth-generation composite femurs were implanted with a posterior-stabilizing femoral component of total knee arthroplasty. All femurs were osteotomized to produce a AO/OTA 33-A3 fracture pattern and four different constructs were tested: (1) non-locking plate; (2) polyaxial locking plate; (3) intramedullary fibular strut allograft with polyaxial locking plate; (4) retrograde intramedullary nail. The composite femurs underwent non-destructive tests to determine construct stiffness in axial and torsional cyclic loading. The final testing consisted of quasi-static axial loading until failure. Results Under cyclic torsional loading, the retrograde intramedullary nail was less stiff than non-locking plate, polyaxial locking plate and intramedullary fibular strut allograft with polyaxial locking plate ( p  = 0.046). No differences were detected in cyclic axial loading between the different constructs. During quasi-static axial loading to failure, the intramedullary nail achieved the highest axial stiffness while the non-locking plate showed the lowest ( p  = 0.036). Conclusions The intramedullary fibular strut allograft with polyaxial locking plate did not prove to be significantly better to the polyaxial locking plate only in a periprosthetic distal femur fracture model.
ISSN:0341-2695
1432-5195
DOI:10.1007/s00264-015-2764-0