Coupling Device and Distal Femoral Replacement for Periprosthetic Supracondylar Femur Fractures with an Ipsilateral Total Knee and Hip Replacement

HSS Journal: Volume 10, Issue 1

Matthew J. Grosso, BS

Cleveland Clinic Lerner College of Medicine, Cleveland Clinic

Joseph Lipman, MS

Director of Device Development, Hospital for Special Surgery


Mathias P. Bostrom, MD

Attending Orthopaedic Surgeon, Hospital for Special Surgery
Professor of Orthopaedic Surgery, Weill Cornell Medical College

Abstract

Background

Periprosthetic supracondylar fractures in the setting of an ipsilateral total knee and hip replacement are a rare but serious orthopedic challenge.

Description of Technique

In this unique situation, we consider insertion of a custom coupling device with a distal femoral replacement as an appropriate surgical solution that allows for stability and preserves hip and knee functionality, while not relying on the poor healing potential of the remaining intercalary femoral bone.

Patients and Methods

We report the outcomes of two patients who underwent this custom coupling procedure.

Results

These custom devices resulted in successful outcomes with restoration of ambulatory function and range of motion at greater than 14 months follow-up.

Conclusions

We found that this technique provides sufficient stability and preserves functionality in a difficult-to-treat patient population. The results indicate that this technique may be considered as an alternative to more invasive procedures including total femoral replacement and complete femoral allograft constructs.

Level of Evidence: Therapeutic Study Level IV. See “Levels of Evidence” for a complete description.
Work Performed at Hospital for Special Surgery, New York, New York

This article appears in HSS Journal: Volume 10, Issue 1.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.

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