Survivorship, complications, and outcomes following distal femoral arthroplasty for non-neoplastic indications.
Bone Jt Open
; 3(3): 173-181, 2022 Mar.
Article
em En
| MEDLINE
| ID: mdl-35227074
ABSTRACT
AIMS:
Endoprosthetic reconstruction with a distal femoral arthroplasty (DFA) can be used to treat distal femoral bone loss from oncological and non-oncological causes. This study reports the short-term implant survivorship, complications, and risk factors for patients who underwent DFA for non-neoplastic indications.METHODS:
We performed a retrospective review of 75 patients from a single institution who underwent DFA for non-neoplastic indications, including aseptic loosening or mechanical failure of a previous prosthesis (n = 25), periprosthetic joint infection (PJI) (n = 23), and native or periprosthetic distal femur fracture or nonunion (n = 27). Patients with less than 24 months' follow-up were excluded. We collected patient demographic data, complications, and reoperations. Reoperation for implant failure was used to calculate implant survivorship.RESULTS:
Overall one- and five-year implant survivorship was 87% and 76%, respectively. By indication for DFA, mechanical failure had one- and five-year implant survivorship of 92% and 68%, PJI of 91% and 72%, and distal femur fracture/nonunion of 78% and 70% (p = 0.618). A total of 37 patients (49%) experienced complications and 27 patients (36%) required one or more reoperation. PJI (n = 16, 21%), aseptic loosening (n = 9, 12%), and wound complications (n = 8, 11%) were the most common complications. Component revision (n = 10, 13.3%) and single-stage exchange for PJI (n = 9, 12.0 %) were the most common reoperations. Only younger age was significantly associated with increased complications (mean 67 years (SD 9.1)) with complication vs 71 years (SD 9.9) without complication; p = 0.048).CONCLUSION:
DFA is a viable option for distal femoral bone loss from a range of non-oncological causes, demonstrating acceptable short-term survivorship but with high overall complication rates. Cite this article Bone Jt Open 2022;3(3)173-181.
Distal femoral replacement; Distal femur; Fracture; Mechanical failure; Megaprosthesis; Periprosthetic joint infection; Total joint; Trauma; aseptic loosening; distal femoral fractures; femoral arthroplasty; femoral bone loss; mechanical failure; nonunion; periprosthetic distal femur fractures; periprosthetic joint infection (PJI); reoperations; wound complications
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Base de dados:
MEDLINE
Tipo de estudo:
Risk_factors_studies
Idioma:
En
Revista:
Bone Jt Open
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos