High reoperation and mortality rate after distal femoral replacement for periprosthetic knee fracture in the elderly

Pujol, Oriol; Jubert, Nayana Joshi; Núñez, Jorge; Pijoan, Joan; Castellet, Enric; Minguell, Joan

doi:10.1007/s00590-022-03225-y

Cited by 2 publications

(1 citation statement)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mortality was unsurprisingly high in this geriatric population with 13.2% after one year. Much higher mortality rates up to 36% in the first year have been reported in case series [ 20 ]. This is comparable to the meta-analysis of Mechas et al [ 12 ] who reported a pooled 1-year mortality of 10% (95% CI 6–18).…”

Section: Discussionmentioning

confidence: 99%

High revision rates and mortality after distal femoral replacement for periprosthetic distal femoral fractures: analysis from the German Arthroplasty Registry (EPRD)

Lützner¹,

Melsheimer²,

Steinbrück³

et al. 2023

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

Purpose This study was initiated to analyze the outcome after distal femoral replacement (DFR) for periprosthetic distal femoral fractures (PDFF). Methods Data from the German Arthroplasty Registry (EPRD) were analyzed. A total of 626 patients could be identified with a DFR for PDFF. Mean age was 78.8 years, and 84.2% were female. Revisions and mortality were analyzed and compared with patient groups with a similar procedure (revision total knee arthroplasty) or similar general condition (fracture total hip arthroplasty, hip hemiarthroplasty). Matched-pair-analyses were performed. Results Within one year after surgery, 13.2% of the patients had died and further 9.4% were revised. Within four years, 32.7% had died and 19.7% were revised. Revisions were nearly twice as high as in the comparison groups. Periprosthetic infection (PJI) was the most frequent cause for revision, resulting in a PJI rate of 12.8%, which was lower in the comparison groups. Mortality after DFR was as similar high as after fracture hip arthroplasty. Conclusion PDFF are a serious injury, and the necessary surgical treatment has a high risk of complications. Every third patient after DFR for PDFF had died and every fifth patient needed revision within 4 years after surgery. Efforts should be undertaken to provide optimal treatment to these high-risk patients to reduce unfavorable outcomes. Level of evidence III. Registration of clinical trials As this is a registry-derived study of data of the German Arthroplasty Registry (EPRD), no registration was performed.

show abstract

Section: Discussionmentioning

confidence: 99%