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 Table of Contents    
LETTER TO EDITOR  
Year : 2015  |  Volume : 49  |  Issue : 6  |  Page : 680
Management of implant-stable distal femoral periprosthetic fractures by distal femoral locking plate: A retrospective studyAuthor's reply


Department of Orthopedic and Joint Replacement Surgery, Global Hospitals, Chennai, Tamil Nadu, India

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Date of Web Publication3-Nov-2015
 

How to cite this article:
Yadav A. Management of implant-stable distal femoral periprosthetic fractures by distal femoral locking plate: A retrospective studyAuthor's reply. Indian J Orthop 2015;49:680

How to cite this URL:
Yadav A. Management of implant-stable distal femoral periprosthetic fractures by distal femoral locking plate: A retrospective studyAuthor's reply. Indian J Orthop [serial online] 2015 [cited 2019 Dec 12];49:680. Available from: http://www.ijoonline.com/text.asp?2015/49/6/680/168756
Sir,

We read with interest the article by Thukral et al. "Management of distal femoral periprosthetic fractures."[1]

We found a large number of posterior cruciate (PC) substitution total knee arthroplasty (TKA) (25 of 31) with fractures across their data intriguing. The lack of sizing data seems to suggest that PC substitution TKA, is a risk factor for fracture. It has been a question of considerable speculation that removal of bone from the intercondylar notch of the femur during TKA may impact vulnerability to subsequent periprosthetic fracture. The volume of the bone removed in the "box cut" varies – across manufacturers. Specifically, are the smaller sizes of prosthetic femurs more predisposed to such a fracture? Sizing data analysis could also influence treatment decision-making. If smaller sized knees with poorer residual bone stock after fracture [2] were prone to adverse outcomes, they could be selected for a different mode of surgical care such as lower femoral prosthetic replacement instead of internal fixation.

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Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Thukral R, Marya SK, Singh C. Management of implant-stable distal femoral periprosthetic fractures by distal femoral locking plate: A retrospective study. Indian J Orthop 2015;49:199-207.  Back to cited text no. 1
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2.
Ebraheim NA, Liu J, Hashmi SZ, Sochacki KR, Moral MZ, Hirschfeld AG. High complication rate in locking plate fixation of lower periprosthetic distal femur fractures in patients with total knee arthroplasties. J Arthroplasty 2012;27:809-13.  Back to cited text no. 2
    

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Correspondence Address:
Ajit Yadav
Department of Orthopedic and Joint Replacement Surgery, Global Hospitals, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5413.168756

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