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Survivorship, complications, and outcomes following distal femoral arthroplasty for non-neoplastic indications
Sobol, Keenan Rhys Fram, Brianna R. Strony, John T. Brown, Scot A.
Sobol, Keenan Rhys
Fram, Brianna R.
Strony, John T.
Brown, Scot A.
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2022-03-01
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http://dx.doi.org/10.1302/2633-1462.33.bjo-2021-0202.r1
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.
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Sobol KR, Fram BR, Strony JT, Brown SA. Survivorship, complications, and outcomes following distal femoral arthroplasty for non-neoplastic indications. Bone Jt Open. 2022;3(3):173-181. doi:10.1302/2633-1462.33.BJO-2021-0202.R1
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British Editorial Society of Bone & Joint Surgery
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Bone & Joint Open, Vol. 3, No. 3
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