Randomized trial investigates incidence and risk factors of tibial fractures in total knee arthroplasty, suggesting improved recognition can enhance outcomes.
Key Points
This study aims to summarize the incidence, mechanisms, and risk factors associated with intraoperative tibial periprosthetic fractures during total knee arthroplasty.
Review of intraoperative risk factors and mechanisms observed during primary and revision total knee arthroplasties.
Analysis of fracture occurrence during specific high-force surgical steps, focusing on keel preparation and component impaction.
Assessment of early outcomes related to fracture recognition and management during surgery.
Intraoperative tibial fractures occur in about 0.1 to 0.5% of primary total knee arthroplasties, increasing to 1.5% during revisions.
Fractures typically occur during keel preparation and final component impaction, with 90 to 100% of cases identified at these stages.
High rates of union and implant survivorship exceeding 95% reported at a mean follow-up of 6 years when fractures are recognized and managed intraoperatively.