Patient safety in distal femoral resection knee arthroplasty for non-tumor indications: a single-center consecutive cohort study of 45 patients

Yasemin Corap*, Michael Brix, Claus Emmeluth, Martin Lindberg-Larsen

*Corresponding author for this work

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Abstract

Background: Distal femoral resection knee arthroplasty may be a viable option for several indications other than bone tumors. Resection knee arthroplasty appears to be becoming more common, but patients requiring this type of surgery are often elderly and with high comorbidity. The aim of this study was to report in-hospital complications, readmissions, reoperations, and mortality after distal femoral resection knee arthroplasty for non-tumor indications. Methods: We retrospectively identified a consecutive cohort of 45 knees (45 patients) treated with distal femoral resection knee arthroplasty in a single institution between 2012 and 2021. Indications for surgery were failure of osteosynthesis (8), primary fracture treatment (2), periprosthetic fracture (22), and revision arthroplasty with severe bone loss (13). A major reoperation was defined as a major component exchange procedure or amputation. Mean follow-up was 3.9 years. Results: The mean age was 71.3 years (SD 12.3), and 64.4% were female; 8.9% were ASA I, 40% ASA II, and 51% ASA III. Median length of stay was 7 days (range 3–19) with no major in-hospital complications, but 55.6% (n = 25) required blood transfusion. The 90-day readmission rate was 17.8% (n = 8), of which 50% was prosthesis-related. Four patients (8.9%) underwent major reoperation due to infection (n = 2), mechanical failure (n = 1), or periprosthetic fracture (n = 1). The mortality rate was 0% ≤ 90 days and 2.2% ≤1 year. Conclusions: Distal femoral resection knee arthroplasty in this fragile patient population appears to be a viable and safe option considering that it is a limp salvage procedure most cases.

Original languageEnglish
Article number199
JournalBMC Musculoskeletal Disorders
Volume23
ISSN1471-2474
DOIs
Publication statusPublished - 3. Mar 2022

Keywords

  • Distal femoral replacement
  • Patient safety
  • Periprosthetic fracture
  • Resection knee arthroplasty
  • Revision knee arthroplasty
  • Arthroplasty, Replacement, Knee/adverse effects
  • Knee Joint/surgery
  • Humans
  • Male
  • Treatment Outcome
  • Reoperation/adverse effects
  • Patient Safety
  • Female
  • Aged
  • Femoral Fractures/surgery
  • Retrospective Studies
  • Cohort Studies

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