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Interprosthetic femoral fractures: management challenges

Authors Rozell JC, Delagrammaticas DE, Schwarzkopf R

Received 22 March 2019

Accepted for publication 14 August 2019

Published 16 September 2019 Volume 2019:11 Pages 119—128

DOI https://doi.org/10.2147/ORR.S209647

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Melinda Thomas

Peer reviewer comments 2

Editor who approved publication: Professor Clark Hung


Joshua C Rozell,1 Dimitri E Delagrammaticas,2 Ran Schwarzkopf1

1Department of Orthopaedic Surgery, NYU Langone Orthopaedic Hospital, New York, NY, USA; 2Central Coast Orthopedics, San Luis Obispo, CA, USA

Correspondence: Ran Schwarzkopf
NYU Langone Orthopaedic Hospital, 301 East 17th St, Suite 1402, New York, NY 10003, USA
Tel +1 212 598 2783
Email Ran.Schwarzkopf@nyulangone.org

Abstract: Interprosthetic femur fractures are a rare but serious complication following total hip and knee arthroplasty. Classification systems have focused not only on diagnosis but also on treatment algorithm. Critical to the evaluation of patients with these fractures are an assessment of fracture location, bone quality, and the presence of stemmed implants. The gold standard for fracture fixation is locked plating with bicortical and unicortical screws, supplemented with wires or cables as needed. For patients with compromised bone stock or insufficient bony area for fixation, allograft augmentation with struts or interprosthetic sleeves may be used. For fractures with severe bone loss, conversion to a megaprosthesis or total femur replacement may be warranted.

Keywords: interprosthetic, total knee arthroplasty, total hip arthroplasty, revision, periprosthetic fracture


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