TOTAL HIP-REPLACEMENT AFTER MULTIPLE PERI PROSTHETIC FRACTURES BETWEEN IPSILATERAL HIP AND KNEE PROSTHESES IN CHRONIC POLYARTHRITIS - REPORT ON 2 PATIENTS

Periprosthetic femur fractures are one of the most severe complication s in hip surgery. Osteoporosis as seen in patients with rheumatoid art hritis could favour such fractures, which are located mostly between t he stems of hip and knee prostheses. A traumatic event is not even req uired. The fracture rate increases with predisposing factors, such as preliminary changes of the prosthesis or osteoporosis. This paper repo rts two patients with rheumatoid arthritis (males, 54 and 71 years old ) with femur fractures after total hip and knee replacements. Both had a severe osteoporosis caused by a long term steroid therapy. Consecut ively, both patients showed refractures of the femur with loosening of the osteosynthetic material, so that a total femur replacement was re quired. However, both patients are able to walk. To reduce the risk of femur fractures between the tips of knee and hip prostheses it is adv isible to use knee prostheses without a proximal intramedullary stem. In this way pressure stress is reduced.