Campbell ST et al. J Orthopedic trauma. 2019;doi:10.1097/BOT.0000000000001431.

Campbell ST et al. J Orthopedic trauma. 2019;doi:10.1097/BOT.0000000000001431.

Published results show that the insufficient profile of the pre-formed distal femoral locking plate results in plate-bone mismatch, which is worse after total knee arthroplasty.

Sean T. Campbell, MD, and colleagues determined the bone plate distance of 53 patients who underwent TKA. The researchers digitally combined four standard-length, pre-contoured distal femoral locking plates (Synthes 4.5 LCP, DePuy Synthes; Smith & Nephew 4.5 Peri-Loc, Smith & Nephew, Stryker 5.0 AxSOS, Stryker; and Zimmer NCB, Zimmer Biomet) digitally templated to each patient's preoperative and postoperative X-rays, and compared the average plate bone distance between the manufacturer and the X-rays before and after TKA.

According to the results, all tested implants have insufficient contours in all patients. Researchers found that the preformed distal femoral locking plate after TKA has a poor fit. The distance between the plate and the bone is about 6.6 mm to 8 mm before surgery and about 8.2 mm to 8.6 mm after surgery. The results showed that Synthes implants had the lowest plate-to-bone distance before TKA, while Smith & Nephew implants had the lowest plate-to-bone distance after TKA. The researchers found that the increase in lamellar bone was even greater in women, at 16%, compared to 8% in men.

"In this study, we found that in all the patients studied, the four different distal femoral locking plates had insufficient contours, which meant that there was a gap between the plate and the distal femoral metaphysis," Campbell told Healio.com /Orthopedics. "When planning to use a steel plate as a reduction aid, this is related to the fracture fixation setting. If the proximal part is in contact with the bone plate in an under-profile area, it may lead to poor reduction. The surgical treatment of distal femoral fractures using these implants Doctors should be aware of this and avoid misusing the steel plate as a reduction template." – Casey Tingle

Disclosure: The Campbell report has no relevant financial disclosures. Please refer to other authors' full research on relevant financial disclosures.

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