title: Management of periprosthetic femoral fractures after total knee arthroplasty using a distal femoral allograft.
abstract: 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.
authors.affiliation: Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Mourad
authors.initials: M
authors.lastname: Kassab
authors.forename: Paul
authors.initials: P
authors.lastname: Zalzal
authors.forename: Gregorio M S
authors.initials: GM
authors.lastname: Azores
authors.forename: Ari
authors.initials: A
authors.lastname: Pressman
authors.forename: Boaz
authors.initials: B
authors.lastname: Liberman
authors.forename: Allan E
authors.initials: AE
authors.lastname: Gross
mesh_terms: 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