A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures — An alternative treatment option

Atrey, Amit; Hussain, Nasir; Gosling, O; Giannoudis, Peter V.; Shepherd, A; Young, S. K.; Waite, Jonathan

doi:10.1016/j.jor.2016.12.006

Cited by 27 publications

(17 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Significant concerns for regular adoption of this practice include the safety of performing complex surgery on frail patients, an increased risk of associated complications most especially infection and costs involved [40–42]. Recent studies reporting on the viability of distal femoral replacement as an option are promising [43–45], and future research efforts are required to better prove the safety and efficacy of this practice.…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes and analysis of risk factors for non-union in locked plating of closed periprosthetic and non-periprosthetic distal femoral fractures in a retrospective cohort study

et al. 2019

View full text Add to dashboard Cite

Background The primary aim was to compare the outcomes of locked plating of closed distal femur periprosthetic and non-periprosthetic fractures by testing the hypothesis that outcomes would be worse in the periprosthetic group. The secondary aim of this study was to identify risk factors for non-union. Methods A single-center study over an 8-year period utilizing a retrospective cohort design was performed. Sixty-eight patients with periprosthetic fractures and 57 patients with non-periprosthetic fractures met inclusion criteria for the study. There was a significant difference between groups in mean age (80.1 years periprosthetic vs. 70.9 years non-periprosthetic ( p < 0.001)). Statistical analysis between groups was used to assess the outcomes of time to union, incidence of non-union, post-operative functionality, incidence of complications, progression to revision surgery, and mortality. A secondary multivariable analysis was used to assess risk factors for non-union and factors positively associated with union. Results There were no significant differences in outcomes between groups. Union rates were 83.8% (57/68) in the periprosthetic group and 78.9% (45/57) in the non-periprosthetic group ( p = 0.648). Comminution was identified as a significant risk factor for non-union ( p = 0.005). Use of a submuscular technique had a significant positive association with union ( p = 0.006). Conclusions Outcomes of surgical treatment for periprosthetic and non-periprosthetic distal femur fractures are similar. There is a significant risk of non-union in locked plating of both groups.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes and analysis of risk factors for non-union in locked plating of closed periprosthetic and non-periprosthetic distal femoral fractures in a retrospective cohort study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The outcomes including length of stay and mortality are discussed and summarised in Table 1 [3,[9][10][11][12][13][14]. Table 1 includes five studies that directly compared the two surgical techniques.…”

Section: Resultsmentioning

confidence: 99%

“…The Link Endo-Model® (Link Orthopaedics, Hamburg, Germany) rotational hinge knee, on the other hand, is an implant that does not require full resection of condylar bone as a prosthesis that is used in complex primary and revision arthroplasty surgery. Its use in the trauma setting, however, has undergone minimal research to warrant its regular use [ 9 ]. Implants can be cemented or uncemented; however, the tendency is to cement the implants in situ, with osteoporotic bone being commonplace in the patient demographic affected by these injuries [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Distal Femoral Replacement as a Primary Treatment Method for Distal Femoral Fractures in the Elderly

Onubogu¹,

Relwani²,

Grewal³

et al. 2021

Cureus

View full text Add to dashboard Cite

Distal femoral fractures account for 3-6% of all femoral fractures with a similar demographic as patients suffering from proximal femoral fractures. The mortality risk can be high in such injuries, which has prompted NHS England to extend the scope of the Best Practice Tariff to include all fragility fractures of the femur. Poor bone quality, intra-articular extension, and significant comminution can make these fractures difficult to manage with fixation techniques, while early mobilisation is a key outcome in the treatment of this injury.In this study, a comprehensive literature search was performed based on keywords, and abstracts were reviewed to identify relevant articles. The following factors were analysed: time to surgery, time to full weight-bearing, the average hospital stay, post-operative mobility status, and complications.A total of 233 abstracts were identified using the pre-determined search criteria, and, subsequently, articles were excluded following author review. A total of 10 relevant articles were included in this review, with five used for review and comparison between distal femoral replacement (DFR) and fixation. This resulted in a sample of 200 patients treated with DFR with over 87% ambulatory at follow-up and a re-operation rate of 13.3% compared to 78% and 13.5%, respectively, in those treated with open reduction internal fixation (ORIF) procedure.Despite a limited pool of evidence, the literature suggests that DFR offers an option that potentially allows immediate weight-bearing and leaves most patients ambulatory at follow-up. Although DFR is more costly than other operative techniques, it avoids complications associated with fixation such as non-union and can reduce the risk of further surgery through direct complications or a need for delayed arthroplasty, which is deemed more complex secondary to fixation. Early mobilisation is a key step in reducing morbidity and mortality among this cohort of patients, and a procedure such as DFR should be more widely considered to help achieve this outcome.

show abstract

“…A review of the literature yields a small number of reported cases of distal femoral replacement in acute trauma not involving a knee replacement ( Table 1 ). 8 – 13 Some authors consider hinged knee replacement as distal femoral arthroplasty; however, the distal femoral metaphysis is retained in some prostheses. The authors agree with Clement et al.…”

Section: Discussionmentioning

confidence: 99%

Bilateral distal femoral endoprosthesis for trauma

et al. 2020

View full text Add to dashboard Cite

In this paper, we describe the outcome of bilateral distal femoral endoprosthesis for the management of acute severe trauma. We also review the literature to ascertain the published functional results of distal femoral endoprosthesis for acute trauma of native knees. In severely comminuted intra-articular fractures, such as those our patient sustained, reconstruction is not always possible, and predictable outcomes can rarely be assured with conviction. Endoprosthesis is an established treatment modality for replacement after resection in limb salvage surgery. In this regard, there is a limited but vital role that endoprosthesis can play in acute complex trauma. We demonstrate a good short-term outcome when bilateral endoprostheses are utilised for complex distal femur trauma.

show abstract

A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures — An alternative treatment option

Cited by 27 publications

References 45 publications

Comparison of outcomes and analysis of risk factors for non-union in locked plating of closed periprosthetic and non-periprosthetic distal femoral fractures in a retrospective cohort study

Comparison of outcomes and analysis of risk factors for non-union in locked plating of closed periprosthetic and non-periprosthetic distal femoral fractures in a retrospective cohort study

Distal Femoral Replacement as a Primary Treatment Method for Distal Femoral Fractures in the Elderly

Bilateral distal femoral endoprosthesis for trauma

Contact Info

Product

Resources

About