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<p>Periprosthetic fractures of the knee pose an increasing challenge, especially when osteosynthesis is not promising. In these cases, revision arthroplasty offers an effective, albeit technically demanding, treatment option. The most relevant decision criteria are prosthesis stability, the extent of bone loss, the location of the fracture, and the patient’s general condition and mobility. The goal is to restore a&#xa0;pain-free, stable, and well-aligned knee joint that allows for mobilization as early as possible. Treatment success depends on precise preoperative assessment, correct indication, and adequate management of bone defects. The Anderson Orthopaedic Research Institute (AORI) classification serves as an established basis for defect assessment and implant selection. Various strategies are available for reconstruction—from cement and screw augmentation to biological procedures such as impaction bone grafting to metal augments, cones, sleeves, and structural allografts. In cases of extensive defects and unstable conditions, the use of megaprostheses may be necessary. Modern modular implant systems enable individualized, zone-specific reconstruction with high primary stability and good functional results. Despite considerable technical challenges, revision prosthetics is an effective strategy for restoring a&#xa0;pain-free, stable, and resilient knee joint, which is a&#xa0;reliable curative option, especially for older and more fragile patients with complex fractures.</p>

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Revisionsprothetik bei periprothetischen Frakturen

  • 期刊论文

  • 发表日期：

    2026年1月16日

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  • Nikolaus Floimayr,
  • Johannes Beckmann,
  • Laurent Harder,
  • Michael Worlicek

摘要

Periprosthetic fractures of the knee pose an increasing challenge, especially when osteosynthesis is not promising. In these cases, revision arthroplasty offers an effective, albeit technically demanding, treatment option. The most relevant decision criteria are prosthesis stability, the extent of bone loss, the location of the fracture, and the patient’s general condition and mobility. The goal is to restore a pain-free, stable, and well-aligned knee joint that allows for mobilization as early as possible. Treatment success depends on precise preoperative assessment, correct indication, and adequate management of bone defects. The Anderson Orthopaedic Research Institute (AORI) classification serves as an established basis for defect assessment and implant selection. Various strategies are available for reconstruction—from cement and screw augmentation to biological procedures such as impaction bone grafting to metal augments, cones, sleeves, and structural allografts. In cases of extensive defects and unstable conditions, the use of megaprostheses may be necessary. Modern modular implant systems enable individualized, zone-specific reconstruction with high primary stability and good functional results. Despite considerable technical challenges, revision prosthetics is an effective strategy for restoring a pain-free, stable, and resilient knee joint, which is a reliable curative option, especially for older and more fragile patients with complex fractures.