Ilizarov external fixation for a periprosthetic tibial fracture in severe osteoporosis: a case report

• Published in: BMC musculoskeletal disorders 2020-03, Vol.21 (1), p.145-145, Article 145
• Main Authors: Nozaka, Koji, Miyakoshi, Naohisa, Sato, Takeshi, Shimada, Yoichi
• Format: Article
• Language: English
• Subjects: Aged, 80 and over; Alendronate; Ambulation aids; Arthroplasty; Arthroplasty, Replacement, Knee - adverse effects; Care and treatment; Case Report; Case reports; Diagnosis; Elderly; External Fixators; Female; Fracture repair; Fractures (Injuries); Humans; Ilizarov external fixator; Injuries; Internal fixation; Knee injuries; Knee replacement arthroplasty; Musculoskeletal diseases; Orthopedic fixation devices; Orthopedic surgery; Osteoporosis; Osteoporosis - diagnostic imaging; Osteoporosis - surgery; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - surgery; Periprosthetic Fractures - diagnostic imaging; Periprosthetic Fractures - etiology; Periprosthetic Fractures - surgery; Periprosthetic tibial fracture; Severity of Illness Index; Tibia; Tibial Fractures - diagnostic imaging; Tibial Fractures - surgery; Time; Total knee arthroplasty
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-020-3176-x

The incidence of periprosthetic fractures after total knee arthroplasty (TKA) is rising due to the increasing number of TKAs performed annually and the growing elderly population. A periprosthetic fracture of the proximal tibia following TKA is a rare injury that may be a challenging clinical scenario. The case of an 84-year-old woman who sustained a periprosthetic tibial fracture 10 years after a TKA is presented. This patient had multiple risk factors. The fracture was not deemed amenable to conventional treatment because the bone fragment was too small. This patient underwent fixation of her tibial fracture above the TKA using a five-ring Ilizarov external fixator. This allowed immediate full weight-bearing. The fixator was removed at 12 weeks, at which time the fracture was solidly healed. At the most recent follow-up, 2 years from injury, she was fully weight-bearing without walking aids and had a knee range of motion (ROM) of 0-110°. To the best of our knowledge, this is the first report in which Ilizarov external fixation has been used for a periprosthetic tibial fracture after TKA.