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General Orthopaedics

Treatment of periprosthetic tibial plateau fractures in unicompartmental knee arthroplasty: Plates versus cannulated screws

The South African Orthopaedic Association (SAOA) 58th Annual Congress



Abstract

Introduction

Periprosthetic medial tibial plateau fractures (TPF) are rare but represent a serious complication in unicompartmental knee arthroplasty (UKA). Most common treatment of these fractures is osteosynthesis with canulated screws or plates.

Aim

The aim of this study was to evaluate these two different treatment options of periprosthetic fractures. The hypothesis was that osteosynthetic treatment with plates show significantly higher maximum fracture loads than fixation with cannulated screws.

Materials and Methods

12 matched paired fresh frozen tibias with periprosthetic tibial plateau fractures were used for this study. In group A osteosyntheses with angle-stable plates were performed, whereas in group B cannulated screws were utilized to fixate the periprosthetic fractures. DEXA bone density measurement and standard X-rays (ap and lateral) were accomplished before loading the tibias under standardised conditions with a maximum load of up to 10.0kN.

Results

In the plate group all tibias fractured with a median load of Fmax=2.64 (0.45–5.68) kN, whereas in the group with cannulated screws fractures occurred at a mean load of Fmax=1.50 (0.27–3.51) kN. The difference was statistically significant with p<0.05.

Discussion

Angle-stable plates showed significantly higher fracture load resistance than fixation with cannulated screws. Therefore osteosynthesis with angle-stable plates in periprosthetic tibial plateau fractures should be recommended.

MULTIPLE DISCLOSURES