Understanding Periprosthetic Knee Fractures: Causes, Symptoms, and Treatment
Periprosthetic knee fractures are fractures or breaks occurring around artificial knee implants, typically following knee replacement surgery, also known as knee arthroplasty. These fractures can happen during or after surgery and often involve the patella, tibia, or femur (kneecap, shinbone, and thighbone). Women are at a higher risk than men for these fractures.
Risk Factors
Several factors contribute to periprosthetic knee fractures, including:
- Falls or trauma
- Rheumatoid arthritis
- Age-related bone weakening
- Prolonged use of corticosteroids
- Mechanical stresses from the implant
- Neurological issues
- Vision or balance problems
- Revision surgery (replacing faulty prosthetic parts)
Symptoms
Symptoms of periprosthetic knee fractures typically include pain, swelling around the knee, an inability to bear weight, and leg deformity.
Diagnosis
Diagnosis involves a thorough examination by a doctor, followed by injury stabilization to prevent further damage. Imaging tests such as X-rays, MRIs, or CT scans may be ordered, along with blood tests.
Treatment
Treatment options depend on the severity of the fracture:
- Non-surgical Methods: Casting or bracing may be used for non-displaced fractures.
- Surgical Methods: Most periprosthetic knee fractures require surgical intervention, often performed under general or regional anesthesia. The complexity of the surgery increases with factors like multiple bone fragments or weak bones. Surgical options include:
- Joint-Revision Surgery: For fractures caused by a loose implant, joint-revision involves removing the old implant and replacing it with new components to treat the fracture.
- Open Reduction and Internal Fixation (ORIF): Fractured bone fragments are fixed together with screws without replacing the implant. Both surgeries may involve bone grafting to strengthen fractured or weakened areas.
After Surgery
Following surgery, patients may stay in the hospital for a few days. Antibiotics are prescribed to prevent infections, and blood-thinning medications reduce the risk of clots. Pain management may involve a combination of non-steroidal anti-inflammatory drugs (NSAIDs) and opioids.
Rehabilitation
Recovery typically includes rehabilitation in a specialized center. Initially, physical therapists assist patients in using walking aids and gradually bear partial weight. Specific exercises are introduced as healing progresses to improve mobility and strength.
By understanding the causes, symptoms, and treatment options for periprosthetic knee fractures, patients can actively participate in their recovery process and improve their outcomes.
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