title: A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures - An alternative treatment option.
abstract: BACKGROUND
  Although the use of an endoprosthesis for distal femoral fractures remains a valid treatment option the widespread use is in its infancy.
  
  
  METHODS
  In this retrospective case series, we review cases of distal femoral fracture treated with endoprosthetic replacement (EPR). The outcomes we assessed were the time to start mobilising, the time to discharge, morbidity and mortality as well as an Oxford knee score to assess pain and function and also the early survivorship. 6 of the 11 from the cohort had existing Total Knee Replacements (TKRs) in situ.
  
  
  RESULTS
  There were 11 knees in our cohort with a mean age of 81.5 years (range 52-102 years). The median time to follow up was 3.5 years (range 1.6 to 5.5 years). The median times to theatre was 3 days and to discharge was 16 days. Oxford functional and pain scores were 32/48.
  
  
  CONCLUSIONS
  In the appropriate patient and fracture pattern, Endoprosthetic knee replacement is an excellent option in the treatment of distal femoral fractures whether associated with an existing TKR or not. The implant is more costly than traditional open reduction and internal fixation, but the earlier return to full mobility post-operatively may save on hospital/care home stay and free up hospital space and minimise complications.
authors.affiliation: St Michael's Hospital, Toronto, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Atrey
authors.affiliation: Michigan University, USA.
authors.forename: N
authors.initials: N
authors.lastname: Hussain
authors.affiliation: SW Training Rotation, UK.
authors.forename: O
authors.initials: O
authors.lastname: Gosling
authors.affiliation: Orthopaedics and Traumatology, Leeds, UK.
authors.forename: P
authors.initials: P
authors.lastname: Giannoudis
authors.affiliation: Warwick Hospital Orthopaedic Research Unit, UK.
authors.forename: A
authors.initials: A
authors.lastname: Shepherd
authors.affiliation: Warwick Hospital Orthopaedic Research Unit, UK.
authors.forename: S
authors.initials: S
authors.lastname: Young
authors.affiliation: Warwick Hospital Orthopaedic Research Unit, UK.
authors.forename: J
authors.initials: J
authors.lastname: Waite
keywords: Distal femoral fracture treatment; Endoprosthesis; Fracture femur; Knee replacement; Trauma