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<h2>Introduction</h2> Periprosthetic fractures following total knee arthroplasty are a potentially devastating complication to both the patient and the surgeon. Complication rates of treatment reported in the literature range widely, from 25 to 75 percent, even in the hands of both skilled and experienced surgeons 1 - 4 . A meta-analysis of 195 fractures in twelve published reports of ipsilateral supracondylar femoral fractures demonstrated complication rates of 30 percent with both nonoperative and operative treatment methods 5 . Various treatment modalities have been utilized to manage these challenging fractures. The purpose of this review is to analyze the prevalence, pathogenesis, mechanism of injury, risk factors, classification, and treatment of these fractures. <h2>Supracondylar Femoral Fractures</h2> <h3>Prevalence and Pathogenesis</h3> The reported prevalence of supracondylar femoral fracture following total knee arthroplasty has ranged from 0.3 to 2.5 percent 3 , 6 - 12 . Various factors have been implicated in the pathogenesis of this fracture. These include stress-shielding from the anterior flange of the femoral component, inadequate osseous remodeling due to postoperative hypovascularity, a relative difference in elastic modulus between the implant-covered distal part of the femur and the femoral cortex, endosteal ischemia from metal or bone cement 13 , 14 ,
Journal of Bone and Joint Surgery – Wolters Kluwer Health
Published: Jan 1, 2001
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