Periprosthetic Fractures

It is a privilege to serve as the guest editor of this “Special Focus Issue” of The Journal of Knee Surgery on the topic of periprosthetic fractures about the knee. I have selected three papers that I believe will be valuable to readers interested in this topic. First, Dr. Borade and colleagues contribute a thorough review article describing surgical techniques for minimally invasive plate osteosynthesis for peri- and interprosthetic fractures. This article also includes a review of the literature that provides the reader with up-to-date information to manage all types of periprosthetic fractures about the knee, including interprosthetic fractures, and both primary or revision components.

A new technique that is attracting significant interest for problematic distal femoral fractures is that of combined nailing and plating. Because of this, Dr. Mirick was requested to provide a specific article detailing the use of this specific surgical approach to periprosthetic fractures of the distal femur. Readers of this article will find a nice summary of the indications, contraindications, and surgical technique.

Finally, any series of articles on these injuries would not be completed without a discussion on distal femoral replacement (DFR). Dr. Khan provides a nice summary of the current belief regarding DFR as a treatment option for periprosthetic fractures of the knee, describing the technique, outcomes, and complications.

I hope readers, after reviewing these three manuscripts, will have an updated understanding of the state-of-the-art related to treating periprosthetic knee fractures, for internal fixation as well as arthroplasty options, and the technical subtleties of these various techniques for surgical management of patients with periprosthetic fractures around total knee arthroplasty.