Knee Surg Relat Res  
Femoral Periprosthetic Fractures after Total Knee Arthroplasty: New Surgically Oriented Classification with a Review of Current Treatments
Seung Joon Rhee, MD1, Jae Young Cho, MD2, Yoon Young Choi, MD3, Takeshi Sawaguchi, MD4, and Jeung Tak Suh, MD1
1Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan; 2Department of Orthopedic Surgery, Haeundae Bumin Hospital, Busan; 3Department of Diagnostic Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea; 4Department of Orthopedics and Joint Reconstructive Surgery, Toyama Municipal Hospital, Toyama, Japan
Correspondence to: Seung Joon Rhee, MD
Department of Orthopedic Surgery, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea
Tel: +82-51-240-7248, Fax: +82-51-247-8395
E-mail: rheefury@naver.com
Received: June 4, 2017; Revised: July 28, 2017; Accepted: August 3, 2017; Published online: April 30, 2018.
© Korean Knee Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: As the number of total knee arthroplasties (TKAs) increases, the incidence of femoral periprosthetic fractures after TKA is also increasing. This review aimed to suggest a new surgically oriented classification system for femoral periprosthetic fractures.
Methods: We investigated the classifications, and current treatment trends for femoral periprosthetic fractures after TKA by means of a thorough review of the relevant literature.
Results: Numerous studies reported good results of surgical treatment with modern fixatives including locking compression plates and retrograde intramedullary nails. However, few classifications of femoral periprosthetic fractures reflect the recent developments in surgical treatment.
Conclusions: We recommend that surgical management be considered the first-line treatment for femoral periprosthetic fractures after TKA. Our new classification will help in deciding the surgical treatment option for femoral periprosthetic fractures after TKA.
Keywords: Femur, Periprosthetic fracture, Arthroplasty, Classification, Plate, Osteosynthesis


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