title: Total knee arthroplasty for salvage of failed internal fixation or nonunion of the distal femur.
abstract: Seventeen patients with a mean age of 66 years had total knee arthroplasty (TKA) performed to salvage failed internal fixation or nonunion of the distal femur. Two patients died at less than 2 years, both of whom were unrevised. The remaining 15 were followed for a mean of 5 years. Three arthroplasties failed, 1 by infection and 2 by mechanical failure. The 5-year survivorship free of revision for aseptic failure was 91% (72%-100%). There were 5 intraoperative complications (29%) and 5 postoperative complications (29%). The mean Knee Society pain score improved from 2 (range, 0-10) to 89 (range, 63-97), and the mean functional score improved from 2 (range, 0-25) to 45 (range, 10-90). TKA provided reliable pain relief and functional improvement for the great majority of patients. Functional scores and prosthesis survivorship, however, were inferior to those reported for primary TKA. The surgeries were difficult, and intraoperative and postoperative complications were common.
authors.affiliation: Florida Orthopedic Institute, Temple Terrace, Florida 33637, USA.
authors.forename: George J
authors.initials: GJ
authors.lastname: Haidukewych
authors.forename: Bryan D
authors.initials: BD
authors.lastname: Springer
authors.forename: David J
authors.initials: DJ
authors.lastname: Jacofsky
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Berry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D018572:Disease-Free Survival; D019544:Equipment Failure Analysis; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation; D016019:Survival Analysis; D017211:Treatment Failure