title: Distal Femoral Replacement for Acute Distal Femoral Fractures in Elderly Patients.
abstract: OBJECTIVE
  To evaluate outcomes and complications using cemented modular distal femoral replacement in elderly patients with distal femoral fractures.
  
  
  METHODS
  Retrospective chart review, case series.
  
  
  METHODS
  A Level 1 and Level 2 trauma center, both tertiary referral hospitals.
  
  
  METHODS
  Eighteen patients older than 60 years (average age 77 years) who had cemented distal femoral replacement for distal femoral fractures (comminuted, intraarticular, osteoporotic, arthritic) between 2005 and 2013. Patients with previous knee surgery were excluded.
  
  
  METHODS
  Cemented modular distal femoral replacement.
  
  
  METHODS
  Implant status, complications, Knee Society Score, Musculoskeletal Tumor Society score, and Western Ontario and McMaster Osteoarthritis Index.
  
  
  RESULTS
  All patients were extremely or very satisfied with their outcomes. For patients with functional outcome data, Knee Society Score averaged 85.7 with a functional score of 35, Musculoskeletal Tumor Society score averaged 19.2, and Western Ontario and McMaster Osteoarthritis Index score averaged 23.1 at an average follow-up of 2.3 years. Range of motion was 1-99 degrees. Implant-related complications occurred in 2 patients (11%); one required revision to total femoral replacement because of periprosthetic fracture and the other had a deep infection that required exchange of the components. No patient had aseptic loosening or patellar maltracking. There were no perioperative deaths or late amputations.
  
  
  CONCLUSIONS
  Cemented modular distal femoral replacement is a viable treatment option in elderly patients that permits immediate full weight-bearing, with most patients returning to preoperative functional status.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee-Campbell Clinic, Memphis, TN.
authors.forename: Clayton C
authors.initials: CC
authors.lastname: Bettin
authors.forename: John C
authors.initials: JC
authors.lastname: Weinlein
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Toy
authors.forename: Robert K
authors.initials: RK
authors.lastname: Heck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome