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Thursday, October 7, 2010, 16:30-17:20Session A8: Periprosthetic Fractures in THAWhat Can We Do With Periprosthetic Fractures?*Pavel Zigo - ASKLEPIOS Orthop.Clinic Hohwald - Neustadt in Sachsen, GermanyThomas-Peter Ranke - Asklepios Orthopaedic Hospital Hohwald - Neustadt in Sachsen,GermanySusanne Kalich - ASKKLEPIOS Orthopaedic Hospital Hohwald - Neustadt in Sachsen,Germany*Email: pavelzigo@web.deWHAT CAN WE DO WITH PERIPROSTHETIC FRACTURES ?ŽIGO P., RANKE T.-P., KALICH S.ASKLEPIOS Orthopaedic Clinic Hohwald, GermanyHead of the Department T.P.Ranke, M.D.Aim: Periprosthetic fractures are usually observed in patients aged over 65 years. Theincidence of postoperative periprosthetic femur and tibia fractures is rising with increasingnumber of hip and knee joint replacements and the increasing life expectancy. The aetiology ofperiprosthetic fractures is multifactorial. Minimal trauma is causal for the fracture in most cases.Other risk factors are: generalized osteoporosis, loosening of the prosthesis and revisionarthroplasty. Our aim is restoration of the patient's pre-fracture functional status.Method: Between 2004 and 2009 in the Asklepios Orthopedic Clinic Hohwald 118 patients (82women, 36 men) were operated because of periprosthetic fractures. Mean patient age at surgerywas 71 years (range 60-87). The right treatment depends on the location of the fracture and thestability of the implant. Very important is also the quality of bone and the patient’s generalstate of health.Results: A successful surgical treatment requires a careful preoperative planning. The type ofthe fracture with or without prostheses instability and with or without bone defect all haveinfluence on the type of patients surgery. Two patients died within one year. There were 2cases of infection and cases of 5 late healing. Fixation with different plates was used for 67fractures, at intact and undamaged endoprosthesis was used usually osteosynthesis with “LessInvasive Stabilisation System” plate (LISS, NCB). It combines high primary stability with thebiological advantages of a slide-insertion plate osteosynthesis.. Retrograde nailing was possiblein 5 patients and 8 further with screws and cerclage wiring. In 38 cases we changed theendoprosthesis partially or completely. We reconstructed prosthetic damage or periprostheticfractures with bone defect using modular prostheses. This system allows a large number ofadditional components and their combination with cone blocks for reconstruction of severe bonefile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]