Management of periprosthetic femoral fractures after total knee arthroplasty using a distal femoral allograft.
This study is a review and discussion of 12 consecutive patients who were revised with a distal femoral allograft for periprosthetic supracondylar fractures of the femur associated with poor bone quality by the same surgeon between 1990 and 2001. Two were lost to follow-up. The average age was 65 years, and the mean follow up was 6 years. Charts were reviewed to identify complications and graft survivorship. Functional assessment consisted of the modified Hospital for Special Surgery (HSS) knee score and the MOS 36-ITEM Short Form Health Survey. Radiographs were evaluated by 3 independent observers to determine graft union, resorption, and component loosening. The average postoperative HSS score and SF-36 were 75 and 88, respectively. Mean flexion was 100 degrees. Nine patients achieved union and were able to fully bear weight. Three patients required more surgery as a result of postoperative complications. Radiographs showed no migration, no loosening, and good interface union in 9 of the 10 patients available for follow-up. We concluded that this is a viable salvage procedure for this type of injury.
Kassab
Mourad
M
Mount Sinai Hospital, Toronto, Ontario, Canada.
Zalzal
Paul
P
Azores
Gregorio M S
GM
Pressman
Ari
A
Liberman
Boaz
B
Gross
Allan E
AE
D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D016208:Databases, Factual; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D013997:Time Factors; D014184:Transplantation, Homologous