Periprosthetic Tibia Fracture M97.119A

ICD-9 Classification / Treatment
Etiology / Epidemiology / Natural History Associated Injuries / Differential Diagnosis
Anatomy Complications
Clinical Evaluation Follow-up Care
Xray / Diagnositc Tests Review References


Periprosthetic Tibia Fracture ICD-10


A- initial encounter

D- subsequent encounter

S- sequela

Periprosthetic Tibia Fracture Etiology / Epidemiology / Natural History

  • 996.41 mechanical loosening of prosthetic joint
  • 996.44 peri-prosthetic fracture around prosthetic joint 
  • 996.45 periprosthetic osteolysis

Periprosthetic Tibia Fracture Anatomy


Periprosthetic Tibia Fracture Clinical Evaluation


Periprosthetic Tibia Fracture Xray / Diagnositc Tests

  • Consider ESR and CRP.  11% of periprosthetic fractures have concomitant infection.  (Chevillotte CJ, Ali MH, Trousdale RT, Larson DR, Gullerud RE, Berry DJ. Inflammatory laboratory markers in periprosthetic hip fractures. J Arthroplasty. 2009 Aug;24(5):722-7)

Periprosthetic Tibia Fracture Classification / Treatment

  • Type I: involve the tibial plateau
  • Type II: occur adjacent to the stem of the tibial component:  often loose and require revision arthroplasty with diaphyseal-engaging intramedullary tibial stem.
  • Type III: distal to the tibial stem.  A=standard management of tibial fracture.  B= loose require revision arthroplasty with diaphyseal-engaging intramedullary tibial stem +/- ORIF. 
  • Type IV: fractures involve the tibial tubercle. 
  • Subclassifications: A with a well-fixed implant; B with a loose implant; and C, occurring intraoperatively.

Periprosthetic Tibia Fracture Associated Injuries / Differential Diagnosis


Periprosthetic Tibia Fracture Complications


Periprosthetic Tibia Fracture Follow-up Care


Periprosthetic Tibia Fracture Review References

  • Felix NA, Stuart MJ, Hanssen AD. Periprosthetic fractures of the tibia associated with total knee arthroplasty. Clin Orthop Relat Res. 1997 Dec;(345):113-24. 
  • Dennis DA. Periprosthetic fractures following total knee arthroplasty. Instr Course Lect. 2001;50:379-89.
  • Duncan CP, ICL 1995;44:293
  • Parvizi J, JBJS 2004;86A:8
  • Younger AS, ICL 1998;74:251
  • Lee SR, ICL 2004;53:111