Periprosthetic supracondylar femur fractures following total knee arthroplasty

Periprosthetic supracondylar femur fractures following total knee arthroplasty (TKA) are an infrequent, but devastating, complication. From 1998 to 2000, we treated 30 supracondylar femur fractures above TKAs. Eighteen fractures were managed with retrograde intramedullary rod fixation (FIMR) and the other 12 fractures with traditional open reduction with internal fixation (ORIF). Follow-up averaged 3 years, with Knee Society knee scores being 84 and 82, respectively. Complications included 1 above-knee amputation for deep sepsis and 1 nonunion with varus alignment. FIMR appears to be the treatment of choice when it is feasible. However, traditional ORIF also may yield satisfactory results in those designs that cannot accommodate retrograde FIMR fixation. (C) 2004 Elsevier Inc. All rights reserved.