1. High revision rates and mortality after distal femoral replacement for periprosthetic distal femoral fractures: analysis from the German Arthroplasty Registry (EPRD).
- Author
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Lützner, Jörg, Melsheimer, Oliver, Steinbrück, Arnd, and Postler, Anne Elisabeth
- Subjects
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PROSTHESIS-related infections , *TOTAL knee replacement , *PAIRED comparisons (Mathematics) , *HEMIARTHROPLASTY , *TREATMENT effectiveness , *DESCRIPTIVE statistics , *RESEARCH funding , *PERIPROSTHETIC fractures , *FEMORAL fractures - Abstract
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. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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