Subtrochanteric fracture of the femur following knee replacement surgery: A case series and review of the literature

• Published in: International journal of surgery case reports Vol. 114; p. 109143
• Main Authors: Vosoughi, Fardis, Vaziri, Arash Sharafat, Shayan-Moghadam, Ramin, Nejad, Erfan Babaei
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.01.2024; Elsevier
• Subjects: Case Series; Knee replacement surgery; Subtrochanteric fracture; Knee replacement surgery; Subtrochanteric fracture; Case series
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2023.109143

Knee arthroplasties as an effective intervention is primarily performed in patients with primary osteoarthritis and rheumatoid arthritis. Risk of hip fracture may be either decreased or increased in patients with Knee arthroplasties. There is conflicting evidence in this regard. Over the years, some studies have reported the occurrence of hip fractures following this operation as a rare but severe complication. The aim of the present case series was to report diagnosis and treatment of the mentioned five cases. During a period of two years, five patients with a diagnosis of a subtrochanteric fracture and history of total knee arthroplasty who referred to hospital were selected to include in the present case series. the presence of RA and treatment with glucocorticoids, a reduction of BMD following knee replacement surgery, and ultimately, an increase in physical activity and movement after the arthroplasty due to the improvement of preoperational pain, may all contribute in a complex manner to the observed outcome of increased fracture risk in the hip following TKA. In summary, special care including using medications to improve BMD should be taken to minimize the risk of such an event. •Knee arthroplasties as an effective intervention is performed in patients with primary osteoarthritis and rheumatoid arthritis•Risk of hip fracture may be either decreased or increased in patients with Knee arthroplasties•The presence of RA and treatment with glucocorticoids, a reduction of BMD following knee replacement surgery, and an increase in physical activity and movement after the arthroplasty due to the improvement of preoperational pain, may all contribute in a complex manner to the observed outcome of increased fracture risk in the hip following TKA•Using medications including alendronate to improve BMD, treatment of patients with RA with medications other than glucocorticoids, and application of some new types of knee prosthesis to attenuate decreasing BMD are among the most important strategies for reducing the risk of subtrochanteric fracture of the femur