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Fractures After Total Knee Replacement

Causes, Symptoms, Diagnosis, and Treatment

What Are Fractures After Total Knee Replacement?

A fracture after total knee replacement (TKR) is a break in the bones surrounding the knee implant, typically affecting the femur (thigh bone), tibia (shin bone), or patella (kneecap). These fractures are known as periprosthetic fractures and can occur due to trauma, falls, or weakened bone structure.

🔹 Common in: Older adults, osteoporotic patients, and individuals with previous knee surgeries.
🔹 Severity: Can range from minor cracks to severe fractures requiring revision surgery.

Causes & Risk Factors

  • Falls or Trauma
  • Osteoporosis or Weak Bones
  • Loosening of the Knee Implant
  • Excessive Stress or Wear on the Knee Joint
Symptoms of Fractures After Knee Replacement
  • Severe pain & swelling around the knee joint.
  • Difficulty in standing or walking.
  • Visible deformity or misalignment of the knee.
  • Inability to bear weight on the affected leg.
  • Increased instability or looseness in the knee joint.
Diagnosis of Periprosthetic Fractures
  • Physical Examination: Evaluating swelling, tenderness, and implant stability.
  • X-rays: Determines the fracture location, type, and severity.
  • CT Scan: Provides a detailed 3D view of bone fragments and implant positioning.
  • Bone Density Test (DEXA Scan): Checks for osteoporosis-related bone weakening.

Treatment Options for Fractures After TKR

Non-Surgical Treatment (For Stable Fractures)
  • Immobilization with a knee brace or cast to allow healing.
  • Pain management with medications and ice therapy.
  • Physical therapy after healing to restore knee function.
Surgical Treatment (For Severe or Unstable Fractures)
  • Internal Fixation (Plates & Screws): For fractures around a stable implant.
  • Revision Knee Replacement: If the implant is loose or damaged, a new implant is inserted.
  • Bone Grafting: Used when bone loss is significant to improve stability.
  • External Fixation: In complex fractures, an external frame may be used for stabilization.
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