Treating periprosthetic fractures after arthroplasty with locking compression plates:a preliminary clinical report

Objective To report our clinical experience in surgical treatment for periprosthetic fractures with a stable intramedullary implant after arthroplasty with locking compression plates(LCP).Methods Eight patients(3 men and 5 women)of periprosthetie fractures with a stable intramedullary implant were subjected to a retrospective follow-up study from November 2004 to July 2007.The average age was 66 years(range:61 to 72 years).Five patients underwent total hip arthroplasty,2 patients underwent femoral head replacement,and 1 patient underwent total knee arthroplasty. There were 5 type B1 and 2 type C according to the Vancouver classification in the cases after hip replacement,and 1 typeⅡaccording to the Rorabeck classification in the cases after knee arthroplasty.Locking compression plates,including 4 single LCP,1 dual LCP,and 3 less invasive stabilization system(LISS),were chosen for open or close reduction and internal fixation.Functional exercise started 2 days after surgery,and fully weight bearing were allowed 12 weeks after surgery.Results The mean follow-up was 14.5 months(range:4 to 27 months).All 8 cases had the fractures healed 12 weeks after surgery.Postoperative X-ray showed stable prosthesis and no symptom of loosening.The mean Harris score of the 7 cases after hip replacement was 88.75;and HSS score of 1 case after TKA was 92.No infection or deep venous thrombosis occurred.Conclusions Close or open reduction and internal fixation with LCP is a promising choice for treating periprosthetic fracture after arthroplasty in our preliminary clinical experience.