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

Amrut Borade; Daniela Sanchez; Harish Kempegowda; Hemil Maniar; Rodrigo Fernando Pesantez; Michael Suk; Daniel S. Horwitz

doi:10.1055/s-0039-1683443

The Journal of Knee Surgery, Table of Contents

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

¹Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania

,

Daniela Sanchez

¹Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania

,

Harish Kempegowda

¹Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania

,

Hemil Maniar

¹Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania

,

Rodrigo Fernando Pesantez

²Department of Orthopedics and Traumatology, Fundación Santa Fe de Bogotá, Bogotá, Colombia

,

Michael Suk

¹Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania

,

Daniel S. Horwitz

¹Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania

› Author Affiliations

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

Full Text

References

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