Minimally invasive implant removal following retrograde medullary nailing of the distal femur

Recently,the retrograde femoral nailing has become a procedure with increas ing acceptance. Indications for the retrograde femur nail are distal femora l fractures including dia- and transcondylar fractures, supracondylar osteo tomies and distal periprosthetic femur fractures after total knee joint rep lacement. Controversial discussion is carried on about the implant removal, which is potentially afflicted with further damage to the knee joint. To mi nimise the operative damage due to the implant removal, an arthroscopic ass isted procedure has been selected. The arthroscopic assisted implant remova l was possible in all of our patients. Intraoperatively, 2/3 of the patient s showed normal age-related findings of the chondral and meniscal structure s. The arthroscopic assisted implant removal is a gentle procedure,which allow s minimal invasive extraction of retrograde femur nails and prevents second ary damage to the knee joint due to the otherwise difficult localisation of the implant. The advantages of this procedure concerning gentleness and di agnostic capabilities are as convincing, that we indicate implant removal o f retrograde femur nails in all younger patients (<60 years), except in per iprosthetic fractures.