{"title":"A Case Report on the Management of Peri-Prosthetic Fracture in a Post-TKA Patient with Rheumatoid Arthritis: Surgical Strategy and Treatment Outcome.","authors":"P M Mervin Rosario, Rathina Easwar V Ra","doi":"10.13107/jocr.2025.v15.i06.5708","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Periprosthetic fractures (PPFs) around the knee following total knee arthroplasty (TKA) present a significant challenge in orthopedic management, particularly in patients with rheumatoid arthritis (RA). These fractures are influenced by factors such as bone stock quality, prosthetic status, polyethylene wear, and fracture reducibility. Proper classification and management strategies are essential to optimize outcomes and prevent complications.</p><p><strong>Case report: </strong>A 52-year-old female with RA sustained a right knee PPF following a trivial fall. Clinical and radiographic evaluation classified the fracture based on prosthetic stability and bone quality:• Type II fracture with a loose prosthesis requiring revision surgery.She underwent staged revision TKA including:1.Definitive surgery with revision TKA and bone grafting in figure.2.Postoperative rehabilitation to restore function figure.</p><p><strong>Conclusion: </strong>Management of PPFs in RA patients requires a comprehensive approach, including preoperative planning, prosthetic evaluation, osteoporosis management, and staged surgical intervention when necessary. This case highlights the importance of addressing osteoporosis alongside osteoarthritis in improving TKA outcomes. Further research is needed to refine treatment strategies for PPFs in RA patients.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"180-184"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159657/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.13107/jocr.2025.v15.i06.5708","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Introduction: Periprosthetic fractures (PPFs) around the knee following total knee arthroplasty (TKA) present a significant challenge in orthopedic management, particularly in patients with rheumatoid arthritis (RA). These fractures are influenced by factors such as bone stock quality, prosthetic status, polyethylene wear, and fracture reducibility. Proper classification and management strategies are essential to optimize outcomes and prevent complications.
Case report: A 52-year-old female with RA sustained a right knee PPF following a trivial fall. Clinical and radiographic evaluation classified the fracture based on prosthetic stability and bone quality:• Type II fracture with a loose prosthesis requiring revision surgery.She underwent staged revision TKA including:1.Definitive surgery with revision TKA and bone grafting in figure.2.Postoperative rehabilitation to restore function figure.
Conclusion: Management of PPFs in RA patients requires a comprehensive approach, including preoperative planning, prosthetic evaluation, osteoporosis management, and staged surgical intervention when necessary. This case highlights the importance of addressing osteoporosis alongside osteoarthritis in improving TKA outcomes. Further research is needed to refine treatment strategies for PPFs in RA patients.
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