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. 2020 Jan-Feb;11(1):160-164.
doi: 10.1016/j.jcot.2019.05.015. Epub 2019 May 22.

Management of periprosthetic distal femur fractures using distal femoral arthroplasty and fixation - Comparative study of outcomes and costs

Tarang Tandon  1 , Baha John Tadros  1 , Adhish Avasthi  1 , Richard Hill  1 , Madhu Rao  1
Affiliations

Management of periprosthetic distal femur fractures using distal femoral arthroplasty and fixation - Comparative study of outcomes and costs

Tarang Tandon et al. J Clin Orthop Trauma. 2020 Jan-Feb.

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.

Keywords: Cost; Distal femoral arthroplasty; Outcome; Peri-prosthetic; Total knee arthroplasty.

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Figures

Fig. 1
Fig. 1
(Pre-operative X-ray).
Fig. 2
Fig. 2
(Post-operative DFA).
Fig. 3
Fig. 3
(Post-op locking plate).
See this image and copyright information in PMC

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