ABSTRACT ABSTRACT Objective: This study aimed to present the clinical outcomes of treatment of periprosthetic femoral fracture after total knee arthroplasty with double plating technique. Methods: With a diagnosis of periprosthetic femoral fracture,21 patients were included from July 2010 to June 2017 from 2 medical institutions.Bilateral approaches was employed in 15 patients intraoperatively(5 male,10 female,mean age:67.2±5.9 years,11type 33-A2,4 type 33-A3, 12 falling,3 traffic accident)for a double plates technique,while medial parapatellar approach was employed in 6 patients(3 male,3female,mean age:64.6±6.0 years,3type 33-A2,3 type 33-A3,5 falling,1 traffic accident)for a double plates technique. Patients were evaluated with operation time,bleeding volume,drain volume,bone healing time,range of motion of knee,the knee function according to HSS grading,and radiology in follow-up. Results: The mean follow-up time of bilateral approaches group was 14.2±2.6 months,while the mean follow-up time of medial parapatellar approach group was 12.6±2.5 months. The operation time and drain volume in bilateral approaches group were (107.2±10.4)min、(213.9±30.4)ml,while in medial parapatellar approach group was (95.4±12.8)min、(256.8±34.2)ml,and the differences were significant(P<0.05). No significant difference was found in bleeding volume or bone healing time in different groups(P>0.05). There were no significant differences in pain,function,range of motion,power,flexion contracture, stability ,total value between different approaches(postoperative 3 months, 12 months)(P>0.05). There were no significant differences in HSS Score grading between different approaches(postoperative 3 months, 12 months)(P>0.05).Signs of delayed bone healing was found in 2 cases(1 in bilateral approaches group,1 in medial parapatellar approach). Infection was found in 1 case(bilateral approaches).There were no significant differences in complications between different approaches(P>0.05). Conclusion: Double plating technique showed excellent outcome in knee function.The medial parapatellar approach enjoyed shorter operation time,while the bilateral approaches had less drain volum. |