High revision rates and mortality after distal femoral replacement for periprosthetic distal femoral fractures: analysis from the German Arthroplasty Registry (EPRD)

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

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.

Details

OriginalspracheEnglisch
Seiten (von - bis)331-338
Seitenumfang8
Fachzeitschrift European journal of orthopaedic surgery & traumatology
Jahrgang34(2024)
Ausgabenummer1
Frühes Online-Datum27 Juli 2023
PublikationsstatusVeröffentlicht - Jan. 2024
Peer-Review-StatusJa

Externe IDs

Scopus 85165928888

Schlagworte

Schlagwörter

  • Aged, Arthroplasty, Replacement, Hip/adverse effects, Arthroplasty, Replacement, Knee/adverse effects, Female, Femoral Fractures, Distal, Femoral Fractures/etiology, Femur/surgery, Humans, Male, Periprosthetic Fractures/etiology, Reoperation/adverse effects, Retrospective Studies

Bibliotheksschlagworte