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High reoperation and mortality rate after distal femoral replacement for periprosthetic knee fracture in the elderly

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To analyze the outcomes of elderly patients with periprosthetic fractures around the knee operated on with a distal femur replacement (DFR).

Methods

We performed a retrospective case series study of eleven elderly patients who underwent DFR due to a periprosthetic fracture. Mean follow-up was 30.1 months (SD 28.1). Demographic, clinical and radiological data were reviewed. A descriptive analysis and a study of survival were conducted. Then, a comparative analysis between the patients who needed reoperation and did not need reoperation, and the patients who died and the patients who were alive during the follow-up was performed.

Results

Mean age was 77.1 years (SD 13.9). Reoperation rate was 36%, being infection the most common complication (27%). The risk of reoperation increased with a longer time between fracture and surgery. The 36.4% of patients died during the follow-up. Older age, need of blood transfusion and need of early reoperation were related to a higher risk of mortality.

Conclusion

DFR could be a valuable option for knee periprosthetic fractures in elderly patients. However, surgeons should be aware of the high reoperation and mortality rate.

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Acknowledgements

We thank Russell Williams of RoundlyWorded.com for his editorial recommendations.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or non-profit sectors.

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Authors and Affiliations

  1. Knee Surgery Unit, Orthopedic Surgery Department, Vall d’Hebron University Hospital, Universitat Autónoma de Barcelona, Pg. Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Oriol Pujol, Nayana Joshi-Jubert, Jorge H. Nuñez, Joan Pijoan, Enric Castellet & Joan Minguell

  2. Universitat Autónoma de Barcelona, Barcelona, Spain

    Oriol Pujol, Nayana Joshi-Jubert, Jorge H. Nuñez, Joan Pijoan, Enric Castellet & Joan Minguell

Authors
  1. Oriol Pujol
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  2. Nayana Joshi-Jubert
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  3. Jorge H. Nuñez
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  4. Joan Pijoan
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  5. Enric Castellet
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  6. Joan Minguell
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Contributions

All authors contributed equally to this work. All authors contributed to the study conception and design, material preparation, data collection and analysis. The first draft of the manuscript was written by Oriol Pujol and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Oriol Pujol.

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Conflicts of interest

The authors declare that they have no conflict of interest.

Ethics approval

We consulted our Center’s Ethics Committee (CEIC). Due to the retrospective and observational nature of our study, it did not need the specific approval of the committee.

The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study or their relatives.

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Patients or their relatives were informed that data concerning their cases might be submitted for publication, and they gave their consent.

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Pujol, O., Joshi-Jubert, N., Nuñez, J.H. et al. High reoperation and mortality rate after distal femoral replacement for periprosthetic knee fracture in the elderly. Eur J Orthop Surg Traumatol 33, 911–918 (2023). https://doi.org/10.1007/s00590-022-03225-y

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  • DOI: https://doi.org/10.1007/s00590-022-03225-y

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