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Results: No further revisions were required in patients who were deceased within 2 years. Inthose with >2 year follow up, there were 4 additional revisions: 1 for infection, 2 for instability,and 1 for periprosthetic fracture. In patients with surviving implants, the mean Harris Hip Scoreimproved from 33 (range 11-49) pre-operatively to 77 (range 55-100), and there was noradiographic evidence of loosening or subsidence at time of final follow up.Conclusions: These outcomes support the use of modular tapered implants as a safe andeffective option for revision arthroplasty of type IIIB and IV femurs.Thursday, October 7, 2010, 16:30-17:20Session A8: Periprosthetic Fractures in THAPeriprosthetic Fractures Associated With Press Fit Stems in Revision TotalKnee Arthroplasty: Incidence, Risk Factors, and Management.*Cara Cipriano - . - ., .Nick Brown - Rush University - Chicago, USAMarc Jacofsky - Core Institute - Sun City West, USAScott Sporer - Rush University - Chicago, USACraig Della Valle - Rush University - Chicago, USA*Email: caracipriano@gmail.comIntroduction: When using press-fit stems in revision total knee arthroplasty (TKA), diaphysealengagement optimizes stability. Attempts to maximize press fit may lead to periprostheticfracture; however, the literature offers no guidance regarding the prevalence or management ofthis complication. The purpose of this study is to report the incidence, risk factors, andoutcomes of these fractures.Methods: 634 Stemmed implants (307 femoral and 327 tibial) from 413 consecutive revisionTKAs were reviewed. Immediate and 6 week post-operative radiographs were examined.Patient age, gender, stem length, diameter, and offset were evaluated as potential risk factors forfracture occurrence using a paired t-test for continuous and a chi-square analysis for categoricalvariables.Results: 15 Periprosthetic fractures (2.4%) were identified including two femoral (0.65%) and13 tibial (4.0%). 10 Fractures were non-displaced, 3 had cortical displacement 2mm. 1 Femur fracture was recognized and fixed intra-operatively with cables.11 patients with non or minimally displaced fractures were allowed to bear weight as toleratedand 2 were protected for 2 weeks. 1 Displaced fracture was braced for 3 months, while the otherwas casted for concomitant extensor allograft reconstruction. All fractures showed radiographicevidence of healing and all patients were able to painlessly bear weight within 6 months. Therewas no evidence of implant migration at a mean of 15 months (range 3-47 months). 1 Patientdeveloped recurrent infection at 10 months; no other complications were identified. With thesample size available for study, no significant differences in age (p=0.09), implant parameters(p=0.06-0.85) or gender (p=0.37) were detected between the fracture and non-fracture groups.Conclusions: Periprosthetic fractures occurred in approximately 2.4% of press-fit stems infile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]