Compress(®) periprosthetic fractures: Interface stability and ease of revision Journal Article

Authors: Tyler, W. K.; Healey, J. H.; Morris, C. D.; Boland, P. J.; O'Donnell, R. J.
Article Title: Compress(®) periprosthetic fractures: Interface stability and ease of revision
Abstract: Periprosthetic fractures after massive endoprosthetic reconstructions pose a reconstructive challenge and jeopardize limb preservation. Compressive osseointegration technology offers the promise of relative ease of prosthetic revision, since fixation is achieved by means of a short intramedullary device. We retrospectively reviewed the charts of 221 patients who had Compress (®) devices implanted in two centers between December, 1996 and December, 2008. The mean followup was 50 months (range, 1-123 months). Six patients (2.7%) sustained periprosthetic fractures and eight (3.6%) had nonperiprosthetic ipsilateral limb fractures occurring from 4 to 79 months postoperatively. All periprosthetic fractures occurred in patients with distal femoral implants (6/154, 3.9%). Surgery was performed in all six patients with periprosthetic femur fractures and for one with a nonperiprosthetic patellar fracture. The osseointegrated interface was radiographically stable in all 14 cases. All six patients with periprosthetic fracture underwent limb salvage procedures. Five patients had prosthetic revision; one patient who had internal fixation of the fracture ultimately underwent amputation for persistent infection. Periprosthetic fractures involving Compress(®) fixation occur infrequently and most can be treated successfully with further surgery. When implant revision is needed, the bone preserved by virtue of using a shorter intramedullary Compress(®) device as compared to conventional stems, allows for less complex surgery, making limb preservation more likely. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. © 2009 The Association of Bone and Joint Surgeons.
Keywords: adolescent; adult; child; controlled study; limb salvage; osteosynthesis; surgical technique; treatment failure; major clinical study; postoperative period; conference paper; comparative study; follow up; medical record review; retrospective study; medical instrumentation; limb; femur; femur fracture; bone radiography; persistent infection; bone regeneration; limb amputation; limb fracture; patella fracture; periprosthetic fracture; preservation
Journal Title: Clinical Orthopaedics and Related Research
Volume: 467
Issue: 11
ISSN: 0009-921X
Publisher: Springer  
Date Published: 2009-11-01
Start Page: 2800
End Page: 2806
Language: English
DOI: 10.1007/s11999-009-0946-z
PROVIDER: scopus
PMCID: PMC2758988
PUBMED: 19565305
Notes: --- - "Export Date: 30 November 2010" - "CODEN: CORTB" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Patrick J Boland
    149 Boland
  2. Carol Morris
    55 Morris
  3. Wakenda Kachina Tyler
    3 Tyler
  4. John H Healey
    476 Healey