+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Distal femoral reconstruction following failed total knee arthroplasty is accompanied with risk for complication and reduced joint function

Distal femoral reconstruction following failed total knee arthroplasty is accompanied with risk for complication and reduced joint function

Bmc Musculoskeletal Disorders 20(1): 47

Substantial bone loss following failed total knee arthroplasty (TKA) represents a major challenge in revision arthroplasty, that can require distal femoral reconstruction (DFR). In this study, we aimed to assess the clinical outcome and the complication frequencies of individuals who underwent DFR with modular megaprostheses. Additionally, we aimed to compare functional outcome measures after DFR in these sophisticated cases to an age-matched control group of total knee prostheses to quantify the potential loss of function. A retrospective chart review of 30 consecutive patients after DFR from 1997 to 2017 with a mean age of 74.38 years (± 10.1) was performed. Complications were classified according to the Henderson classification. Knee Society Score (KSS) was calculated and range of motion (ROM) was assessed. Thirteen (43.3%) patients had at least one complication requiring revision surgery. Revision-free survival was 74.8% at one year, 62.5% at three and 40.9% at 10 years post-op. Soft-tissue failure complications were found in three (10.0%) patients, aseptic loosening in four (13.3%) patients, structural failure in one (3.3%) patient and infection in eight (26.6%) patients. Of those with infection, five (16.6%) experienced ongoing prosthetic joint infection and three (10.0%) developed new infection after distal femur reconstruction. Patients with DFR achieved 69.3% of KSS pain score, 23.1% KSS function score and 76.2% of ROM compared to patients with primary TKA. DFR after failed TKA represents a treatment procedure with high risk for complication in this particular group. Despite the prospect of rapid postoperative mobilization, reduced functionality, range of motion and mobilization have to be considered when choosing this treatment option.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 066446549

Download citation: RISBibTeXText

PMID: 30704448

DOI: 10.1186/s12891-019-2432-4

Related references

Total knee arthroplasty after failed distal femoral varus osteotomy using selectively stemmed posterior stabilized components. Journal of Arthroplasty 26(5): 738-743, 2012

Intercondylar distal femoral fracture. An unreported complication of posterior-stabilized total knee arthroplasty. Journal of Arthroplasty 10(5): 643-650, 1995

Effect of distal femoral flexion angle on sagittal alignment of femoral prosthesis and function recovery after total knee arthroplasty. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 25(1): 38-41, 2012

Patellar reconstruction using distal femoral autograft in a patellectomized patient undergoing total knee arthroplasty. Journal of Arthroplasty 23(6): 939.E1-7, 2008

Distal femoral allograft reconstruction for massive osteolytic bone loss in revision total knee arthroplasty. Journal of Arthroplasty 21(2): 242-248, 2006

Distal femoral replacement with allograft/prosthetic reconstruction for treatment of supracondylar fractures in patients with total knee arthroplasty. Journal of Arthroplasty 7(1): 7-16, 1992

Distal Femoral Rotation Correlates With Proximal Tibial Joint Line Obliquity: A Consideration for Kinematic Total Knee Arthroplasty. Journal of Arthroplasty 33(6): 1936-1944, 2018

Patellar reconstruction following previous patellectomy: a review of the literature and a case series using distal femoral autograft during total knee arthroplasty. Annals of the Royal College of Surgeons of England 99(3): E97-E101, 2017

Reduced joint-awareness in bicruciate-retaining total knee arthroplasty compared to cruciate-sacrificing total knee arthroplasty. Archives of Orthopaedic and Trauma Surgery 138(2): 273-279, 2017

Navigation-assisted total knee arthroplasty for the knee retaining femoral intramedullary nail, and distal femoral plate and screws. Clinics in Orthopedic Surgery 3(1): 77-80, 2011

Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic review. Journal of Orthopaedic Surgery and Research 14(1): 15-15, 2019

Postoperative femoral component rotation and femoral anteversion after total knee arthroplasty in patients with distal femoral deformity. Journal of Arthroplasty 28(7): 1084-1088, 2013

Distal femoral arthroplasty for the treatment of periprosthetic fractures after total knee arthroplasty. Journal of Arthroplasty 25(5): 775-780, 2010

Management of periprosthetic femoral fractures after total knee arthroplasty using a distal femoral allograft. Journal of Arthroplasty 19(3): 361-368, 2004

The use of a revision femoral stem to manage a distal femoral periprosthetic fracture in a well-fixed total knee arthroplasty. Journal of Arthroplasty 27(1): 156-159, 2012