Prophylactic intramedullary femoral rodding during total knee arthroplasty with simultaneous femoral plate removal

• Published in: The Journal of arthroplasty Vol. 13; no. 6; pp. 718 - 721
• Main Author: Ries, Michael D.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.1998
• Subjects: Bone Plates; Female; Femoral Fractures - diagnostic imaging; Femoral Fractures - surgery; femoral intramedullary rodding; femur; fracture; Fracture Fixation, Intramedullary - instrumentation; Fractures, Spontaneous - diagnostic imaging; Fractures, Spontaneous - surgery; Humans; Knee Prosthesis; Middle Aged; Osteoarthritis, Knee - surgery; Osteoporosis, Postmenopausal - diagnostic imaging; Osteoporosis, Postmenopausal - surgery; plate; Postoperative Complications - surgery; Prosthesis Design; Radiography; Reoperation; stress riser; supracondylar; total knee arthroplasty; total knee arthroplasty; femoral intramedullary rodding; stress riser; femur; supracondylar; plate; fracture
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/S0883-5403(98)80019-3

Removal of a plate from the distal femur creates a risk of fracture through the screw holes. This is a particular concern when a total knee arthroplasty is present because supracondylar fracture may occur with minimal trauma. A patient who presents after prior plating of a distal femur fracture with osteoporosis, retained hardware associated with pain, and gonarthrosis severe enough to warrant total knee arthroplasty is often difficult to manage. Prophylactic intramedullary rodding is a well-accepted method of treating pathologic stress risers in the femur. An intramedullary rod can be inserted into the femur at the time of total knee arthroplasty. This method permits simultaneous plate removal and total knee arthroplasty while protecting the femur from postoperative fracture.