Periprosthetic_Fractures_PPT.pptxSession timing 26th oct Timings 7.00 pm to 8.pm Orthopedic Surgery Title: "Periprosthetic Fractures & Bone Biology" - Discuss classification, surgical approaches, and biological considerations in managing periprosthetic

Session timing 26th oct Timings 7.00 pm to 8.pm

Orthopedic Surgery
Title: "Periprosthetic Fractures & Bone Biology"
- Discuss classification, surgical approaches, and biological considerations in managing periprosthetic fractures and failed joint replacements.

1. Management of Periprosthetic Fractures & Failed Joint Replacements Presenter: Dr. K. Ravi Kiran, MS Orthopedics Institution: NIMRA Institute of Medical Sciences, Vijayawada Date: [Insert Date]

2. Introduction Definition of periprosthetic fractures Epidemiology & incidence Common joints affected (hip, knee, shoulder) Relevance in failed joint replacements Visual: X-ray of periprosthetic fracture, incidence chart

3. Etiology & Risk Factors Patient-related: Osteoporosis, age, comorbidities Implant-related: Loosening, malalignment, previous revision Trauma-related: Falls, minor injuries Biological factors: Poor bone stock, infection Visual: Diagram showing fracture around prosthesis, bone quality illustration

4. Classification – Hip Periprosthetic Fractures Vancouver Classification: Type A: Trochanteric region Type B: Around stem (B1: stable, B2: loose stem, B3: loose stem + poor bone) Type C: Distal to stem Clinical significance: Guides surgical approach Visual: Diagram & X-rays for each type

5. Classification – Knee Periprosthetic Fractures Rorabeck & Taylor classification (distal femur): Type I: Undisplaced, stable prosthesis Type II: Displaced, stable prosthesis Type III: Prosthesis loose Patellar fractures: Ortiguera & Berry classification Visual: Diagram & X-rays

6. Principles of Management Stabilize patient & manage comorbidities Assess prosthesis stability Evaluate bone stock Decide between ORIF vs Revision Arthroplasty Consider biological environment & healing potential Visual: Flowchart of management algorithm

7. Surgical Approaches – Hip ORIF: Locking plates, cables, cerclage Revision arthroplasty: Long stems, proximal femoral replacements Approach selection: Lateral, posterior, or combined Tips: Minimize soft tissue damage; preserve blood supply Visual: Intraoperative pictures, implant diagrams

8. Surgical Approaches – Knee Distal femur fractures: Locking plates, retrograde nails TKA revision: Hinged prosthesis in poor bone stock Patellar fractures: Tension band wiring, partial patellectomy Tips: Preserve extensor mechanism; avoid malalignment Visual: Pre- & post-op X-rays

9. Biological Considerations Bone healing in presence of implant Impact of osteopenia & osteoporosis Infection risk & soft tissue condition Strategies to enhance healing: Bone grafting, biologics (BMP, PRP), adequate fixation & load sharing Visual: Diagram of bone biology around prosthesis

10. Complications Non-union & malunion Prosthesis loosening or failure Infection Re-fracture Visual: Clinical photos/X-rays of complications

11. Case Examples Case 1: Hip periprosthetic fracture B2 Case 2: Distal femur fracture Rorabeck II Visual: Pre-op X-ray, intraoperative picture, post-op X-ray

12. Summary / Take-home Points Early diagnosis & classification is key Surgical planning depends on prosthesis stability & bone stock Biological considerations crucial for healing Multidisciplinary approach improves outcomes

13. References Key textbooks & recent journal articles (J Arthroplasty, JBJS, etc.)