{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T01:18:49Z","timestamp":1773191929032,"version":"3.50.1"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Intra-operative fractures in knee revision surgery are relatively rare and have not been well studied. They may occur during joint exposition, removal of the prosthesis or cement, or implantation of trial or original components. The fractures affect both the metaphyseal area and diaphysis of the tibia and femur. Tibial fractures are slightly more common than femur fractures. On the femur, the medial condyle is most frequently affected, followed by the femur diaphysis. The use of non-cemented stems is associated with a greater risk of intra-operative diaphyseal fractures than that of cemented stems. Overall, women and patients with an osteopenic bone structure have a higher risk of fractures. It is common that fractures are diagnosed post-operatively. In these cases, conservative therapy may be successful, depending on the stability of the prosthesis and bones. The most common surgical fixation options are cerclages and screws, followed by stem extensions for bridging the\n\t\t\t\t\tfracture. Plate fixation or use of strut grafts are also sensible therapy options. Overall, intraoperative fractures have a high healing potential with stable and good joint function. The revision rate is still 15%, which is most often caused by peri-prosthetic infection.<\/jats:p>","DOI":"10.1055\/a-1542-9192","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T23:06:26Z","timestamp":1631142386000},"page":"85-91","source":"Crossref","is-referenced-by-count":3,"title":["Intraoperative Fractures of the Tibia and Femur in Knee Revision Surgery"],"prefix":"10.1055","volume":"161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8934-9676","authenticated-orcid":false,"given":"Michael","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Charite \u2013 Universitaetsmedizin Berlin, Germany"},{"name":"Sportklinik Erfurt, Erfurt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uwe","family":"Kahl","sequence":"additional","affiliation":[{"name":"Sportklinik Erfurt, Erfurt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"von Roth","sequence":"additional","affiliation":[{"name":"Knee Endoprosthetics, Sporthopaedicum, Straubing, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Hube","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, OCM Clinic Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,9,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s43019-020-00054-3","article-title":"Intra-operative fractures in primary total knee arthroplasty \u2013 a systematic review","volume":"32","author":"P P Purudappa","year":"2020","journal-title":"Knee Surg Relat Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/s0030-5898(05)70073-0","article-title":"Epidemiology: hip and knee","volume":"30","author":"D J Berry","year":"1999","journal-title":"Orthop Clin North Am"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/s0035-1040(06)75699-9","article-title":"[Intra- and postoperative fractures of the femur in total knee arthroplasty: risk factors in 32 cases]","volume":"92","author":"P Hernigou","year":"2006","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1007\/s11999-009-0876-9","article-title":"Intraoperative fracture during primary total knee arthroplasty","volume":"468","author":"K J Alden","year":"2010","journal-title":"Clin Orthop Relat Res"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1177\/230949901502300218","article-title":"Distal femoral fracture during primary total knee arthroplasty","volume":"23","author":"L A Delasotta","year":"2015","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.otsr.2008.04.002","article-title":"Intraoperative fractures and ligament tears during total knee arthroplasty. 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