Single-stage bilateral distal femur replacement for traumatic distal femur fractures

Neal, David C.; Sambhariya, Varun; Tran, Apollo; Rahman, Shawn K.; Dean, Thad J.; Wagner, Russell; Sanchez, Hugo B.

doi:10.1016/j.artd.2018.10.009

Cited by 9 publications

(5 citation statements)

References 22 publications

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“…Twenty (66.7%) patients did not need home care, 5 (16.7%) received home care every day, and 5 (16.7%) received home care 1-2 times over two weeks. Mobility aids were used by 18 patients (60%) in the form of canes (9), walkers (8), and wheelchairs (1) (Fig. 3.…”

Section: Resultsmentioning

confidence: 99%

“…Distal femoral resection knee arthroplasty may be a viable option for several non-oncologic indications [3,4], but the patients requiring this type of surgery are often elderly and with high medical comorbidity. Only limited data exist on the outcome of distal femoral resection knee arthroplasty for non-oncologic indications, but most of the recently published case series suggest it may be a reasonable treatment option [5,6,7,8,9,10]. The procedure appears to be a relatively safe option in terms of surgical complications and mortality [11].…”

Section: Introductionmentioning

confidence: 99%

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Knee function, quality of life, pain, and living conditions after distal femoral resection knee arthroplasty for non-tumor indications

Corap

Brix

Emmeluth

et al. 2022

Preprint

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Background: Distal femoral resection knee arthroplasty is a limb salvage procedure. The impact of distal femoral resection arthroplasty on patient function and health status is unknown. The aim of this study was to report knee function, quality of life, knee pain, and living conditions after distal femoral resection knee arthroplasty for non-tumor indications. Methods: Of 52 patients (52 knees) undergoing distal femoral resection knee arthroplasty in a single institution between 2012 and 2021, 22 were excluded as 3 patients had ≤ 90 days follow-up, 6 had died, and 13 declined or were unable to participate for unrelated reasons. Thus, 30 patients were included and interviewed by telephone in March 2021 (mean follow-up 3.5 years after surgery). Patient completed the Oxford Knee Score (0-48, 48 best), EQ-5D-5L, and the Copenhagen Knee ROM, and information on pain and living conditions was obtained. Results: The mean age was 67.9 years (SD 13.6), and 21 (70%) were female. Mean total Oxford Knee Score was 29.9 (SD 10.5), mean Copenhagen Knee ROM flexion was 116° (SD 21.6), and mean extension was –2° (SD10.1). Mobility aids were used by 18 (60%) patients, i.e. a cane (30%), walker (26.7%) or wheelchair (3.3%). Mean EQ-5Dindex score was 0.70 (SD 0.22) and mean EQ-5D VAS score was 55.4 (SD 23.9). Nine (30%) patients used paracetamol or NSAID and 2 (6.7%) used opioids for knee pain. Mean VAS knee pain score was 1.30 (SD 2.2) at rest and 2.8 (SD 3.1) when walking. Most (90%) patients lived in their own home, with only 3 patients in nursing homes. Two-thirds (66.7%) required no home care, 5 (16.6%) received home care 1-2 times over 2 weeks, and 5 (16.6%) every day. Conclusion: Distal femoral resection knee arthroplasty appears to be a viable treatment option for non-tumor indications. Acceptable patient outcomes were achieved in terms of functional status and quality of life, especially considering treatment alternatives such as femoral amputation.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Knee function, quality of life, pain, and living conditions after distal femoral resection knee arthroplasty for non-tumor indications

Corap

Brix

Emmeluth

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…In the case reported by Calmet et al [5], internal fixation using 4 cancellous lag screws was performed due to the fracture being open and associated with extensive soft tissue injury. Other treatments of supracondylar distal femur fracture include flexible intramedullary nails [11], plate fixation [12] using condylar plates, locking plates or blade plates [4], buttress plates with screws, total knee arthroplasty which is attempted in osteoporotic patients with severe comminuted fracture or preexisting arthritis [4] and distal femur replacement in patients with a previous total knee replacement [13]. The selection of the definitive fixation is based on the patient's status and the characteristics of the fracture.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Concomitant Open Distal Femur Fractures Associated with Bilateral Quadricipital Tendon Rupture: A Case Report

Darwish

Aouad

Saidy

et al. 2022

Case Rep Orthop Res

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Fractures of the distal femur in young populations are usually due to a high-energy trauma mechanism. They often present with various associated osseous and soft tissue injuries. A case of bilateral open distal femur fractures with associated bilateral quadriceps tendon rupture is presented. This injury has not been previously reported in the literature. A 45-year-old male patient who sustained an axial injury to both his lower limbs after jumping from his house balcony while escaping a fire is presented. He was found to have bilateral open fractures of the distal femurs, associated with bilateral rupture of the quadriceps tendons. Both fractures were repaired via open reduction internal fixation using plate osteosynthesis. The quadriceps tendons were also repaired. Two years later, a persistent right femur nonunion was managed surgically with a re-do plate osteosynthesis and mesenchymal cell injection. The patient is in a good clinical condition after a follow-up of 5 years postoperatively. Rupture of the quadriceps tendon in association with distal femur fractures is a rare finding. However, understanding the mechanics and deforming forces of the fracture is crucial to explain the tendon injury. Open reduction internal fixation with primary repair of the quadriceps has led to successful outcomes in both lower limbs, with restoration of the patient’s baseline of motion and daily living.

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“…Neal DC et al [7] reported their experience of a case of traumatic left open periprosthetic distal femur fracture with right closed intraarticular distal femur fracture with end stage arthrosis treated with single staged distal femur replacement, they concluded that single stage distal femur replacement provides the benefits of early mobilization and accelerated recovery in intraarticular distal femur and periprosthetic fractures.…”

Section: Discussionmentioning

confidence: 99%

Hinged knee arthroplasty in a case of non-union distal femur fracture with implant failure in an elderly individual: A case report

Bhaskaran¹,

Gadod²,

Lakhani³

et al. 2021

Int. J. Case Rep. Orthop.

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Introduction: Distal femur fractures are one of the most common fractures accounting for 0.5% of all fractures with incidence of about 7/100000/year. Majority of the fractures occur in elderly population (above 60 year) with osteoporosis resulting from a low energy trauma. In the younger age group these fractures are associated with high energy trauma. Case report: A 68-year-old male presented with chief complaints of pain and deformity in right knee since 1 year. The patient had a history of distal femur fracture 2 years back for which he was operated twice with distal femur plating and bone grafting. The patient was a known case of diabetes mellitus on medication since 5 years. Radiographs of the right knee in anteroposterior and lateral views were taken, which showed distal femur fracture non-union with a broken locking compression plate with grade 4 knee arthritis. Due to the failure of osteosynthesis twice, and the patient demanding for early mobilization, a single staged procedure with implant removal followed by an arthroplasty using cemented modular distal femur endoprosthesis was planned for the patient. Conclusion:Hinged knee arthroplasty can be considered as a treatment option for patients with distal femur non-union with pre-existing severe knee arthritis. It helps in early weight bearing and return to activities of daily living.

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Single-stage bilateral distal femur replacement for traumatic distal femur fractures

Cited by 9 publications

References 22 publications

Knee function, quality of life, pain, and living conditions after distal femoral resection knee arthroplasty for non-tumor indications

Knee function, quality of life, pain, and living conditions after distal femoral resection knee arthroplasty for non-tumor indications

Bilateral Concomitant Open Distal Femur Fractures Associated with Bilateral Quadricipital Tendon Rupture: A Case Report

Hinged knee arthroplasty in a case of non-union distal femur fracture with implant failure in an elderly individual: A case report

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