Contemporary Distal Femoral Replacements for Supracondylar F
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There is a paucity of data on the outcomes of distal femoral replacements (DFRs) in patients with total knee arthroplasty (TKA) periprosthetic fractures.

Researchers retrospectively identified 49 patients, including 34 after primary TKA, 9 after revision TKA, and 6 conversions for failed ORIF that underwent DFR for a periprosthetic femur fracture. Mean age was 76 years and 40 patients were female. Mean follow-up was 4 years.
Femoral fixation included: 44 cemented stems and 5 cementless stems.

Results:
--Survivorship free from any re-revision at 5 years in the primary and revision cohort was 93% and 18%, respectively.
The revision cohort had a 5.3x higher risk of re-revision.
--Survivorship free from re-revision for aseptic loosening at 5 years in the primary and revision cohort was 93% and 53%, respectively.
--2 of the 3 patients with cementless stems in the primary cohort underwent early re-revision for aseptic loosening, but patients with prior primary TKAs treated with cemented femoral fixation (n=31) had a 97% 5-year survivorship free from re-revision.

Conclusively, patients with periprosthetic fractures around prior primary TKAs treated with DFRs with cemented femoral fixation had a 97% 5-year survivorship free from any re-revision. DFRs for periprosthetic femur fractures around revision TKAs or conversions of failed ORIFs have a 5x increased risk of re-revision.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0883540320312973?dgcid=rss_sd_all
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