Simultaneous Bilateral Distal Femur and Tibia Periprosthetic Fractures after Total Knee Arthroplasty: A Rare Case Report.

Introduction: Incidence of periprosthetic fractures is increasing with the rising number of total knee arthroplasties performed every year. The management of such fractures is challenging due to multiple factors. We reported a rare case with simultaneous bilateral distal femur and tibia periprosthetic fractures managed with open reduction and internal fixation (ORIF) and healed uneventfully.

Case Report: A 64-year-old female came with simultaneous bilateral distal femur (Bilateral Type IIB Rorabeck) and tibia (Bilateral Type IIIB Felix) periprosthetic fractures following road traffic accident. All fractures were managed with ORIF using locking plates. Bony union achieved in 4thpost-operative month without any complication.

Discussion: Management of such fractures can be challenging for orthopedic surgeons due to elderly patients with osteoporotic bone and poor healing potential. This injury is not reported in the literature previously and is quite challenging. At 1-year follow-up, the patient is walking comfortably without support and knee flexion range from 0 to 110° on both sides.

Conclusion: The presentation of such injuries will be increasing in future, and we should be prepared to overcome this challenge. We have managed this case with basic principles of orthopedics, and it healed without any complication.