Is the cause of femoral neck fracture after total knee arthroplasty iatrogenic or stress fracture?

Year 2014, Volume: 31 Issue: 3, 201 - 204, 06.11.2014

Hasan Göçer , Alper Çıraklı

Abstract

Due to the increase in life expectancy, the number of patients with knee osteoarthritis in the society is increasing as well. Treatment options for the early-stage knee osteoarthritis include nonsteroidal anti-inflammatory drugs, intra-articular injections and physical therapy modalities. In patients with advanced stage of osteoarthritis and clinical complaints, by virtue of the advances in surgical experience and implant production, knee arthroplasty becomes more successful and durable. Despite the innovations in implant technology and surgical treatment methods, complication rate increases due to hypertension (HT), osteoporosis (OP) and diabetes mellitus (DM). In this paper, a 67-year-old female patient with femoral neck fracture that was identified 6 months after a total knee arthroplasty performed due to the knee osteoarthritis was discussed in the light of literature.

Keywords

Femoral neck, Fracture, Iatrogenic, Stress, Total knee arthroplasty

References

• Atalar, H., Aytekin, M.N., Gunay, C., Yavuz, O.Y., 2008. Stress fracture of the femoral neck as a complication of revision arthroplasty of the knee: A case report. Acta Orthop. Belg. 74, 418-420.
• Çakmak, S., Mahiroğulları, M., Kürklü, M., Yıldız, C., 2012. Bilateral femoral neck stress fracture following bilateral total knee arthroplasty: A case report. Acta Orthop. Traumatol. Turc. 464, 312-315.
• Fipp, G., 1988. Stress fractures of the femoral neck following total knee arthroplasty. J. Arthroplasty. 3, 347-350.
• Hardy, D.C., Delince, P.E., Yasik, E., Lafontaine, M.A., 1992. Stressfracture of the hip. An unusual complication of total kneearthroplasty. Clin. Orthop. 281, 140-144.
• Hendel, D., Beloosesky, Y., Weisbort, M., 2001. Fracture of the hipafter knee arthroplasty-an unusual case with pain in the knee. Acta Orthop. Scand. 72, 194-195.
• Joshi, N., Pidemunt, G., Carrera, L., Navarro-Quilis, A., 2005. Stress fracture of the femoral neck as a complication oftotal knee arthroplasty. J Arthroplasty. 20, 392-395.
• Khan, F.A., Ikram, M.A., Badr, A.A., Al-Khawashki, H., 1995. Femoral neck fracture: A complication of femoral nailing. Injury. 26, 319-321. Kumm, D.A., Rack, C., Rütt, J., 1997. Subtrochanteric stress fracture of the femur following total knee arthroplasty. The Journal of Arthroplasty. 12, 580-583.
• McElwaine, J.P., Sheehan, J.M., 1982. Spontaneous fractures of the femoral neck after total replacement of the knee. J. Bone. Joint. Surg. Br. 64, 323-325.
• Pankaj, A., Malhotra, R., Logani, V., Bhan, S., 2007. Bilateral femoral neck stress fractures following total knee arthroplasty: A case report and review of literature. Arch Orthop Trauma Surg. 127, 549-552.
• Petje, G., Landsiedl, F., 1997. Stress fracture of the tibia after total knee arthroplasty. Arch Orthop. Trauma. Surg. 116, 514-515.
• Rawes, M.L., Patsalis, T., Gregg, P.J., 1995. Subcapital stress fractures of the hip complicating total knee replacement. Injury. 26, 421-423.
• Sermon, A., Broos, P., Vanderschot, P., 2008. Total hip replacement for acetabular fractures. Results in 121 patients operated between 1983 and 200 Injury. 39, 914-921. doi: 10.1016/j.injury.2007.12.004.
• Sharkey, P.F., Hozack, W.J., Rothman, R.H., Shastri, S., Jacoby, S.M., 2002. Why are total knee arthroplasties failing today? Clin. Orthop. Relat. Res. 404, 7-13. doi: 10.1016/j.arth.2013.07.024.
• Smith, M.D., Henke, J.A., 1988. Pubic ramus fatigue fractures after total knee arthroplasty. A case report. Orthopedics. 11, 315-317.
• Thienpont, E., Simon, J.P., Spaepen, D., Fabry, G., 2000. Bifocal pubic stress fracture after ipsilateral total knee arthroplasty in rheumatoid arthritis. A case report. Acta Orthop Belg. 66, 197-200.