Autogenous Fibula Graft for Periprosthetic Femoral Fractures after Revision Total Hip or Knee Arthroplasty

Yoshio Kumagae and Takaaki Tanaka

Department of Orthopaedic Surgery, NHO Utsunomiya National Hospital, Japan

^*Correspondance to: Takaaki Tanaka 

 PDF  Full Text DOI: 10.25107/2474-1647.2189

Abstract

Periprosthetic femoral fractures after total hip and knee arthroplasty are increasing common complications. With stable prosthesis classified Vancouver type B1, surgical stabilization of the fracture with plate, strut allograft, or a combination of both is recommended. However, allografts have not commonly been used in Japan. In addition, bone formation and stabilization in the fractured site are not easily obtained after revision THA and TKA using long stem. Thus, we used autogenous fibula graft and plate in the treatment of periprosthetic femoral fractures after three revisions THA and one revision TKA. In addition, to reduce donor-site morbidity, Beta-Tricalcium Phosphate (TCP) blocks were placed on the periosteum.The results showed that bone union of femoral fractures was obtained in all patients, and partial reconstruction of fibula was obtained but no complain on donor-site and tibio-fibular joints. In conclusion, a combination of autogenous fibula graft and plate fixation is a useful technique to treat periprosthetic femoral fractures after primary and revision THA or TKA. In addition, reconstruction of fibula using beta-TCP reduced donor-site morbidity.

Keywords

Periprosthetic femoral fracture; Revision arthroplasty; Autogenous fibula graft; Beta-tricalcium phosphate

Cite the article

Kumagae Y, Tanaka T. Autogenous Fibula Graft for Periprosthetic Femoral Fractures after Revision Total Hip or Knee Arthroplasty. Clin Surg. 2018; 3: 2189.