Mortality and Morbidity Associated with Periprosthetic Fracture after Total Knee Replacement

Background: Periprosthetic fractures following total knee arthroplasty are a devastating consequence of an otherwise successful procedure. With an ageing population and extension of total knee arthroplasty to older patients, the rate of these fractures will continue t o rise. The purpose of this study was to observe the mortality and morbidity associated with surgical treatment after periprosthetic fracture of total knee replacement. Methods: We retrospectively identified all patients that were admitted to two institut es with a periprosthetic fracture of total knee arthroplasty over a period of five years. Forty five patients underwent operative stabilization (23males and 22 females): by retrograde nailing (n=9), plate fixation (n=32) and 4 revision total knee arthropla sties. Results: Of the 45 patients, there were 20 fractures united within one year of surgery (average 4.8 range 2 to 11months), there was 3 required further surgery for non union (1 following plating and 2 following retrograde nailing). 9 patients died wi thin 6 months of surgery (7 with 4 weeks of surgery). Conclusion: There is a high mortality associated with periprosthetic surgery in the elderly. There was a higher non union rate with retrograde nailing then plating in this group of patients.