RecruitingNot ApplicableNCT06909916

Weight-Bearing CT and Conventional Periprosthetic Distal Knee Fractures

Assessment of Bone Displacement Under Loading Following Distal Femur Periprosthetic Fracture Repair With Weight-Bearing CT and Conventional CT


Sponsor

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

Enrollment

20 participants

Start Date

Jun 20, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

Total knee arthroplasty (TKA) is a surgical procedure commonly conducted for patients with end-stage knee osteoarthritis, often leading to improved pain relief and function. However, for patients that have suffered an associated periprosthetic fracture, a broken bone that occurs around the implant of a TKA, they may receive sub-optical care due to a lack of a trustworthy assessments for component fixation and fracture healing in the literature. The prevalence of TKA surgeries is increasing annually and is projected to rise further due to an ageing population and obesity issue. By extension to this primary surgery, more Canadians will require an invasive revision surgery that risks patient morbidity and mortality. Thus, it is imperative to set a standard for fixation and bone healing assessments to lessen revision burdens and improve patient outcomes. CT imaging can effectively visualize areas of incomplete bone ingrowth that may be hidden from overlapping anatomy on plain radiographs, which remains the go-to imaging modality for orthopaedic surgeons to assess periprosthetic fracture healing. The purpose of this prospective cross-sectional study is to examine the efficacy of weight-bearing CT as a diagnostic tool for 20 participants who experienced a distal femur periprosthetic fracture and underwent revision surgery using a fracture fixation plate and screws. Participants will be scanned under loaded and unloaded conditions. Radiographic outcomes will be evaluated, including bone segment displacement and its relation to participants' reports of pain.


Eligibility

Min Age: 50 YearsMax Age: 90 Years

Inclusion Criteria5

  • Underwent revision surgery for repair of a distal femur fracture surrounding a primary TKA femoral component using a fracture fixation plate >1 year
  • Age 50-90 years
  • Body mass index up to 40kg/m2
  • Able to provide informed consent
  • Able and willing to do study assessments and follow instructions

Exclusion Criteria4

  • Does not understand English
  • Undergone revision surgery for any other indication
  • Received Intramedullary nail or distal femur replacement
  • Cannot independently stand on one leg in the weight-bearing CT during the inducible displacement exam

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Interventions

OTHERPeriprosthetic Fracture Knee Repaired CT Scans

The investigators will be assessing the use of weight-bearing CT and conventional CT, specifically its imaging, with RSA-like software, for analyzing fracture healing for a periprosthetic distal knee fracture.


Locations(1)

University Hospital - London Health Sciences Centre

London, Ontario, Canada

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NCT06909916


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