Intraoperative Fracture During Staged Total Knee Reimplantation in the Treatment of Periprosthetic Infection

Bone stock during knee reimplantation for infection is compromised and may contribute to intraoperative fracture. This study aims to describe the prevalence of said fractures. A retrospective review was performed of patients who underwent a staged TKA reimplantation for a periprosthetic infection. Patients who sustained an intraoperative fracture were analyzed. The fracture timing, location, and treatment were recorded. Fracture healing, component stability, and need for re-revision were noted. Between 1990 and 2010, 894 reimplantations were performed. Twenty-three fractures occurred in 21 patients (2.3%) with mean follow-up of 56 months (range: 4–122). Thirteen fractures occurred in femora, 7 in tibiae, and 3 in patellae. Four occurred during resection, while 19 occurred during reimplantation. Observation and wires/cables were the most common treatments utilized. At final follow-up, 91% of fractures demonstrated union and 75% of patients demonstrated stable components. Eight patients (38%) required a revision, the majority of which were performed for re-infection.