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J Knee Surg 2019; 32(05): 392-402
DOI: 10.1055/s-0039-1683443
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Minimally Invasive Plate Osteosynthesis for Periprosthetic and Interprosthetic Fractures Associated with Knee Arthroplasty: Surgical Technique and Review of Current Literature

Amrut Borade
1   Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania
,
Daniela Sanchez
1   Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania
,
Harish Kempegowda
1   Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania
,
Hemil Maniar
1   Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania
,
Rodrigo Fernando Pesantez
2   Department of Orthopedics and Traumatology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
,
Michael Suk
1   Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania
,
Daniel S. Horwitz
1   Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania
› Author Affiliations
Further Information

Publication History

10 December 2018

05 February 2019

Publication Date:
28 March 2019 (online)

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Abstract

With the increasing number of total knee arthroplasties (TKAs) being performed, the incidence of periprosthetic fractures adjacent to a TKA is rising. Minimally invasive plate osteosynthesis (MIPO) has proven to be successful for the biological fixation of many fractures. Advances in surgical instrumentation and techniques made MIPO possible for more complex fractures. Periprosthetic fractures are always complicated by problems of soft tissue incisions, scarring, and, of course, the arthroplasty components. MIPO techniques may be particularly suited to these injuries and may make the surgical repair of these fractures safer and more reliable. In this review, case examples are used to define the indications, preoperative planning, implant selection, complications, limitations, and challenges of MIPO for the treatment of periprosthetic fractures about the knee. When considering MIPO for any fracture, we recommend prioritizing an acceptable reduction with biological fixation and resorting to mini-open or open approach when necessary to achieve it. Awareness of the learning curve of the surgical technique, advances in implant designs, the tips and tricks involved, and the limitations of the MIPO is of paramount importance from the orthopaedic surgeon's perspective.

Keywords

periprosthetic fractures - interprosthetic fractures - total knee arthroplasty - MIPO - Minimally invasive plate osteosynthesis

Note

No reproduced copyrighted materials are used within this article. Waiver of patient consent granted by IRB for retrospective chart review.


 

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