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Weight-Bearing CT and Conventional Periprosthetic Distal Knee Fractures

Periprosthetic Fracture Around Prosthetic Joint Implant

Total knee arthroplasty (TKA) is a surgical procedure commonly conducted for patients with end-stage knee osteoarthritis, often leading to improved pain relief and function. However, for patients that have suffered an associated periprosthetic fracture, a broken bone that occurs around the implant of a TKA, they may receive sub-optical care due to a lack of a trustworthy assessments for component fixation and fracture healing in the literature. The prevalence of TKA surgeries is increasing annually and is projected to rise further due to an ageing population and obesity issue. By extension to this primary surgery, more Canadians will require an invasive revision surgery that risks patient morbidity and mortality. Thus, it is imperative to set a standard for fixation and bone healing assessments to lessen revision burdens and improve patient outcomes. CT imaging can effectively visualize areas of incomplete bone ingrowth that may be hidden from overlapping anatomy on plain radiographs, which remains the go-to imaging modality for orthopaedic surgeons to assess periprosthetic fracture healing. The purpose of this prospective cross-sectional study is to examine the efficacy of weight-bearing CT as a diagnostic tool for 20 participants who experienced a distal femur periprosthetic fracture and underwent revision surgery using a fracture fixation plate and screws. Participants will be scanned under loaded and unloaded conditions. Radiographic outcomes will be evaluated, including bone segment displacement and its relation to participants' reports of pain.

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Participation Requirements

  • Sex:

    ALL
  • Eligible Ages:

    50 to 90

Participation Criteria

Inclusion Criteria:

* Underwent revision surgery for repair of a distal femur fracture surrounding a primary TKA femoral component using a fracture fixation plate \>1 year
* Age 50-90 years
* Body mass index up to 40kg/m2
* Able to provide informed consent
* Able and willing to do study assessments and follow instructions

Exclusion Criteria:

* Does not understand English
* Undergone revision surgery for any other indication
* Received Intramedullary nail or distal femur replacement
* Cannot independently stand on one leg in the weight-bearing CT during the inducible displacement exam

Study Location

University Hospital - London Health Sciences Centre
University Hospital - London Health Sciences Centre
London, Ontario
Canada

Contact Study Team

Primary Contact

Brent Lanting, MD

[email protected]
519-685-8500
Backup Contact

Farzan Mohammadreza Mohammadreza, MSc

[email protected]
519-729-8079
Study Sponsored By
London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
Participants Required
More Information
Study ID: NCT06909916