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 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 30 November 2010" - "CODEN: CORTB" - "Source: Scopus" |
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