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Distal Femoral Replacements for Acute Comminuted Periprosthetic Knee Fractures: Satisfactory Clinical Outcomes at Medium-Term Follow-up.
Matar, Hosam E; Bloch, Benjamin V; James, Peter J.
Affiliation
  • Matar HE; Nottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, Nottingham, UK.
  • Bloch BV; Nottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, Nottingham, UK.
  • James PJ; Nottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Arthroplast Today ; 7: 37-42, 2021 Feb.
Article in En | MEDLINE | ID: mdl-33521195
BACKGROUND: Fracture fixation techniques of comminuted periprosthetic distal femoral fractures have high risk of complications. The aim of this study was to evaluate short- to medium-term outcomes of comminuted periprosthetic distal femoral fractures treated with distal femoral replacements (DFR) at a tertiary arthroplasty unit. METHODS: Retrospective consecutive study of all patients who underwent DFR for periprosthetic fractures with minimum 2-year follow-up between 2010 and 2018. Clinical outcomes, surgical complications, revision for any cause, loosening, Knee Society Score and mortality data were collected at final follow-up. RESULTS: Thirty patients with average age 81 years (range, 65-90; 6 males and 24 females) were included. All had comminuted fractures (Rorabeck type-2/3). All patients had cemented DFRs. Three patients (10%) with multiple comorbidities died postoperatively. Average time from admission to being fit for discharge was 9 days (range, 3-14). Clinical outcomes and follow-up were available for 27 patients with a median follow-up duration of 4 years (2-13 years). Complication rate was 7.4% with one reoperation, change of polyethylene insert. None of the components have been revised to date. Average Knee Society Score at final follow-up was 78 (range, 57-92) with median arc of motion flexion-extension being 100° (range, 60°-125°). CONCLUSIONS: In our experience, DFRs for comminuted periprosthetic fractures allow immediate mobilization and rehabilitation leading to satisfactory clinical outcomes with low complication rate for this challenging group of patients. LEVEL OF EVIDENCE: level IV.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Arthroplast Today Year: 2021 Document type: Article Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Arthroplast Today Year: 2021 Document type: Article Country of publication: