title: Supracondylar periprosthetic fractures of the knee in the elderly patients: a comparison of treatment using allograft-implant composites, standard revision components, distal femoral replacement prosthesis.
abstract: The following study is a review of 3 different treatment methods for treating comminuted distal periprosthetic femur fractures in 23 patients over the age of 70 (average age 80, range 70-90). Reconstruction techniques included 7 allograft prosthesis composite (APC), 9 revision systems (RSA), and 7 distal femur endoprosthesis (DFR). Operative time and blood loss were found to be significantly less in RSA and DFR patients compared to the APC patients. Hospital stay was shortest for the DFR patients. No significant difference was found in the 6-week or 6-month Knee Society Scores. Our preliminary results demonstrate that in experienced hands, distal femur endoprosthesis should be considered in patients with advanced age and poor bone quality who require early mobilization.
authors.affiliation: Health Sciences North Orthopaedic Oncology and Adult Reconstruction Program, Northern Ontario School of Medicine, Sudbury, ON, Canada.
authors.forename: Kevan
authors.initials: K
authors.lastname: Saidi
authors.forename: Oren
authors.initials: O
authors.lastname: Ben-Lulu
authors.forename: Matthew
authors.initials: M
authors.lastname: Tsuji
authors.forename: Oleg
authors.initials: O
authors.lastname: Safir
authors.forename: Allan E
authors.initials: AE
authors.lastname: Gross
authors.forename: David
authors.initials: D
authors.lastname: Backstein
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D016025:Bone Transplantation; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005269:Femur / Q000601:surgery; D005593:Fracture Fixation, Internal; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D057068:Periprosthetic Fractures / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies
keywords: allograft prosthesis composite; endoprosthesis; periprosthetic fracture; revision; total knee arthroplasty