Outcomes of distal femoral arthroplasty after periprosthetic fractures : minimum 2-year follow-up

Acta Orthop Belg. 2021 Mar;87(1):111-116.

Abstract

Purpose: distal femoral periprosthetic fracture (DFPPF) is a serious complication following total knee arthroplasty (TKA). Recently, treatment of DFPPF with distal femoral arthroplasty (DFA) has gained popularity because of its posited benefits for both patients and the medical system. Short-term follow-up trials investigating DFA have demonstrated acceptable results with regards to function, pain relief and lower postoperative complications than ORIF in elderly patients. The purpose of the current study was to evaluate a consecutive series of DFPPF treated with DFA, with a minimum 2- year follow-up.

Methods: We performed a retrospective study asses- sing the outcomes of distal femoral arthroplasty (DFA) for patients diagnosed with DFPPF.

Results: Twenty patients were identified. The mean age of patients was 76.3 (SD, 9.41), the average time from the fracture to revision surgery was 6.7 days (SD, 11.35), The average operative time was 93.5 minutes (SD,16.6). The average follow-up time was 50.15 months (SD, 20.87). During this time, two patients (10%) had complications. One patient experienced a knee dislocation and the second patient had recurrent periprosthetic infections. At final follow up, the mean knee society score was 86.25 (SD, 9.44), the mean Forgotten joint score was 62.16(SD, 23.45) and 93.7 percent of patients were ambulatory.

Conclusion: DFA following DFPPF is associated with high success rates and provides patients with the opportunity for return of function in a safe and reliable manner.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Femoral Fractures* / surgery
  • Follow-Up Studies
  • Humans
  • Periprosthetic Fractures* / surgery
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome