Innovative Fixation for Periprosthetic Fracture Around a Knee Replacement

Case Overview:
A 68-year-old lady presented with a fracture around a 7-year-old total knee replacement. She was treated using an interlinked nail-plate combination technique — a modern solution that provides strong fixation and enables early full weight-bearing and knee motion in a hinged brace.

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🦴 Before Surgery – The Challenge

Periprosthetic fractures occur around existing implants and are often difficult to manage due to bone weakness and limited fixation options.

📸 X-ray Before Surgery
(Image 1 & 2) – The preoperative radiographs show a clear fracture line around the previously implanted knee prosthesis.

The main concern was maintaining implant stability while achieving fracture union and early mobility.

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⚕️ Surgical Approach – Interlinked Nail-Plate Combination

Our orthopedic team performed fixation using a nail-plate combination construct, which merges the strength of an intramedullary nail with the rotational stability of a locking plate.

📸 Intraoperative / Post-fixation X-rays
(Image 3 & 4) – Postoperative radiographs show the interlinked construct in place, providing optimal alignment and stability.

This technique allows immediate weight-bearing and controlled knee movement in a hinged brace.

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💪 Recovery and Outcome

The patient began early mobilization soon after surgery, avoiding stiffness and complications associated with immobility.
Within weeks, she achieved:

• Stable fixation
• Functional knee motion
• Independent walking

“Early mobility is the key to recovery after such complex fractures.”

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🩺 Key Takeaway

Periprosthetic fractures around knee replacements can be effectively treated using the nail-plate combination method.
This modern fixation enables faster rehabilitation, reduced complications, and preserved joint motion — offering patients a quicker return to their daily activities.rsonalized physiotherapy, even elderly patients can regain pain-free, independent movement within days.