If you or a loved one has recently had a **total knee replacement**, you probably know that this surgery can dramatically improve your quality of life.... But sometimes, rare complications occur such as fractures around the implant that require immediate attention.... In this blog post, we will cover the full topic of **fracture after knee replacement.. prominent orthopedic surgeon and specialist in Tehran for years Experience in complex orthopedic surgeries provides valuable guidance in this field. Periprosthetic fracture is a bone fracture that occurs around or near an orthopedic implant. This article focuses on periprosthetic fractures after knee replacement. occur and is usually the result of a fall or high-energy injury, such as a motor vehicle accident.. Fortunately, fractures after knee replacement are rare.. Most periosteal fractures occur above the knee bone.. Fractures of the tibia (leg bone) or patella (kneecap) may also occur, but are less common.. ### Causes of Periprosthetic Fractures Fractures after knee replacement are usually caused by falls.. They can also be caused by high-energy injuries such as motor vehicle accidents.. Several things can put people at increased risk for periprosthetic fractures, including: - Having more risk factors for falls, such as muscle weakness, poor vision or poor balance Having a disease that weakens the bones, such as osteoporosis ### Common fracture symptoms after knee replacement The most common fracture symptoms after knee joint replacement are: - Pain around the thigh or knee - Swelling and bruising around the thigh or knee - Inability to bear weight on the injured leg - The affected leg looks shorter or misshapen If you experience these symptoms, see an orthopedic specialist like Dr. Homan Kukbi immediately to prevent the problem from getting worse.. As with many fractures, a person who has a fracture after a total knee replacement is often in significant pain and will likely go straight to the emergency room.... In the emergency room, there are usually several doctors involved in your care.... They will examine the damaged nerve for wear and tear and evaluate #blood flow to the leg.. Tests and Diagnosis **X-rays.** In the emergency room, your doctor will order x-rays of your femur, knee, and tibia, as well as any other areas where you have pain. This allows your doctor to see the entire knee replacement and fracture. X-rays can show: - Bone quality - The number of broken bone fragments - displacement rate (distance between broken pieces) **CT scan.** In some cases, your doctor will also order a CT scan.... CT scan provides three-dimensional images of bony structures.... **Lab tests.** Blood tests and other lab tests can give your doctor important information about your general health and help prepare you for surgery.... ### Stabilization of the injury You will not be allowed to put any weight on the injured leg.... Your doctor may place you in a brace to limit movement at the injury site.... After the initial tests are completed, a decision will be made as to whether you need to be hospitalized... Treatment options for a fracture after knee replacement Most **fractures after knee joint replacement** require surgery.... To determine the right treatment for you, the doctor will consider several factors, including: - Fracture type and location - The quality of the remaining bone - Are the implants loose or not? - Your general medical health Patients with multiple medical conditions that require surgery may stay in the hospital for several days before surgery. This is often because patients undergo additional medical tests to prepare them medically for surgery to reduce the risk of complications.. - Open reduction and internal fixation - Complete knee replacement - A combination of both #### Open reduction and internal fixation If your implant is still firmly attached to the femur and tibia, your doctor may recommend internal fixation to treat the fracture.. During this procedure: - The bone fragments are first shifted to their natural alignment (reduction), then held in place with plates and screws/cables... - In some cases, a metal nail (intramedullary nail) is inserted into the femur to restore stability.... Your surgeon will discuss which procedure is best for you.... #### Joint replacement In some cases of complete fracture of the periprosthetic knee replacement, the implant is loose.... In these cases, the original implant must be removed from the bone and replaced with a new implant.... This is called revision.... Due to the possible loss of bone, the surgeon may use special implants... Finally, if the femur is lost, he may use a special type known to your surgeon, a distal implant.. The surgeon in Will discuss surgery and implants best for your specific injury... If necessary, surgery will be performed as soon as it is medically safe... #### Anesthesia Upon admission, you will be assessed by a member of the anesthesia team... Surgery to treat a periprosthetic fracture Total knee replacement is often done under general anesthesia (you will be put to sleep).... You, the anesthesiologist, and your surgeon will discuss the type of anesthesia to be used... Surgery to repair a fracture can be challenging. It is not uncommon for these surgeries to take more than 3 hours. Factors that increase the complexity of the procedure include: - Low bone quality - Comminuted fracture (several pieces of bone) - In some cases, the presence of bone cement (from the main knee replacement surgery) - Need to work on existing surgical implants After the surgery, you will be taken to the recovery room where you will stay for several hours while your recovery from the anesthesia is monitored.... After you wake up, you will be transferred to the hospital room.... ### Recovery after surgery You will likely stay in the hospital for a few days after surgery.. After surgery, you will likely have intravenous (IV) antibiotics for a while to help prevent infection.. In addition, your surgeon will prescribe blood thinners to help reduce the risk of a blood clot in your leg (deep vein thrombosis).. #### Pain Management After surgery, you will be sore...it's a normal part of the healing process.. Your doctor and nurses will work to reduce your pain, which can help you recover faster after surgery.. You can use a combination of these medications to improve pain relief and reduce the need for opioids. If your pain starts to improve, stop taking them.. If you haven't started to recover after surgery, talk to your doctor... #### Rehabilitation In most cases, physical therapy begins immediately after surgery.... The surgeon will determine how much weight you can put on the healing leg and how much you can bend your knee.... a skilled nurse or visit a rehabilitation center to improve your strength and general health.... ### Possible complications of surgery Complications after surgery for periprosthetic fractures can be serious. The most common complications are: - Infection - Blood clotting - Poor fracture healing - Recurrent fracture - Nerve or vascular damage #### Additional surgery In some cases, it is necessary to repeat the operation to fix the problem. It is important to talk to the orthopedic surgeon about the risks and benefits of this operation before the surgery. Ours!.. For more information or to book an appointment, visit Dr. Homan Cookby's website... Leave your comments in the comments section - your experiences can help others!..