Management of Periprosthetic Distal Femur Fractures Using Distal Femoral Arthroplasty and Fixation - Comparative Study of Outcomes and Costs

Overview

Journal J Clin Orthop Trauma

Specialty Orthopedics

Date 2020 Feb 1

PMID 32002006

Citations 11

Authors

Tarang Tandon

Baha John Tadros

Adhish Avasthi

Richard Hill

Madhu Rao

Affiliations

Soon will be listed here.

Abstract

Purpose: Our study compares the outcome and cost of distal femoral arthroplasty to that of Fixation (Plating/Retrograde Nailing) in the management of distal femur peri-prosthetic fractures.

Methods: We reviewed our database for patients admitted with peri-prosthetic distal femoral fractures between 2005 and 2013 (n = 61). The patients were stratified into 2 groups based on management method. The Distal Femoral Arthroplasty group (Group A) had 21 patients and the Fixation group (Group B) had 40 patients. Outcome & cost were compared. Minimum follow-up was 3 years.

Results: The mean length of stay in group A was 9 days whereas in group B was 32 days. All patients were fully weight bearing by day 3 in group A, compared to a mean of 11 weeks in group B. Mean OKS was 28 and KSS score was 70 in group A compared to 27 and 68 in group B. In group A, there were 2 deaths, 1 superficial infection, and 1 DVT. In group B, there were 6 deaths, 1 failure of fixation, 6 mal-unions, 1 non-union and 2 infections. Overall, the distal femoral arthroplasty procedure costs approximately £9600 and the fixation group costs were on average of £9800.

Conclusion: Distal femoral arthroplasty appears to provide good clinical results, with comparable overall costs to fixation.

Citing Articles

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Periprosthetic Distal Femoral Fractures Around a Total Knee Arthroplasty: a Meta-analysis Comparing Locking compression Plating and Retrograde Intramedullary Nailing.

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Routledge J, Bashir O, Elbeshbeshy M, Saber A, Aqil A Cureus. 2023; 15(9):e45333.

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