Journal of clinical orthopaedics and trauma · 2026
Intra-operative femoral condyle fractures during primary total knee arthroplasty: Incidence, risk patterns, and early outcomes in an Asian cohort.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Shahul Hameed Shaheer, Rajput Rakesh, Uwais P, Basu Aakash, Setua Sayak, Pal Kunal Kanti
Аннотация
BACKGROUND: Intra-operative femoral condyle fractures during primary total knee arthroplasty (TKA) are uncommon but potentially serious complications. While periprosthetic fractures after TKA are well described, intra-operative fractures remain underreported, particularly in Asian populations with smaller skeletal morphology.
METHODS: A retrospective observational study was conducted on 784 consecutive primary TKAs performed in 570 patients between January and December 2024 at a single tertiary centre. All procedures were performed by a high-volume arthroplasty team using a standard medial parapatellar approach. Cases with intra-operative femoral condyle fractures were identified and analyzed for demographic variables, implant design, laterality, robotic assistance, fracture location, and immediate management. Tibial intra-operative fractures were excluded. Patients were followed clinically and radiographically to assess early outcomes and fracture union.
RESULTS: Eight intra-operative femoral condyle fractures were identified, yielding an incidence of 1.02%. Six fractures involved the medial femoral condyle and two involved the lateral condyle. The mean age of affected patients was 65.1 years, and seven of eight were female. Five fractures occurred on the right side. Two cases occurred during same-sitting bilateral TKA. Six fractures were associated with cruciate-retaining implants while the other two with posterior-stabilized implants. Robotic assistance was used in five of the eight fracture cases. All fractures were recognized intra-operatively and managed with immediate fixation using screws without conversion to revision implants. All cases demonstrated satisfactory early clinical recovery and radiographic union.
CONCLUSION: Intra-operative femoral condyle fractures during primary TKA are rare but clinically relevant. Female sex, medial condyle involvement, and technical factors appear contributory. Early recognition and prompt fixation allow favorable short-term outcomes; however, these findings reflect early clinical results and do not represent long-term implant survival.
METHODS: A retrospective observational study was conducted on 784 consecutive primary TKAs performed in 570 patients between January and December 2024 at a single tertiary centre. All procedures were performed by a high-volume arthroplasty team using a standard medial parapatellar approach. Cases with intra-operative femoral condyle fractures were identified and analyzed for demographic variables, implant design, laterality, robotic assistance, fracture location, and immediate management. Tibial intra-operative fractures were excluded. Patients were followed clinically and radiographically to assess early outcomes and fracture union.
RESULTS: Eight intra-operative femoral condyle fractures were identified, yielding an incidence of 1.02%. Six fractures involved the medial femoral condyle and two involved the lateral condyle. The mean age of affected patients was 65.1 years, and seven of eight were female. Five fractures occurred on the right side. Two cases occurred during same-sitting bilateral TKA. Six fractures were associated with cruciate-retaining implants while the other two with posterior-stabilized implants. Robotic assistance was used in five of the eight fracture cases. All fractures were recognized intra-operatively and managed with immediate fixation using screws without conversion to revision implants. All cases demonstrated satisfactory early clinical recovery and radiographic union.
CONCLUSION: Intra-operative femoral condyle fractures during primary TKA are rare but clinically relevant. Female sex, medial condyle involvement, and technical factors appear contributory. Early recognition and prompt fixation allow favorable short-term outcomes; however, these findings reflect early clinical results and do not represent long-term implant survival.