Patient safety in distal femoral resection knee arthroplasty for non-tumor indications: a single-center consecutive cohort study of 45 patients.
Distal femoral replacement
Patient safety
Periprosthetic fracture
Resection knee arthroplasty
Revision knee arthroplasty
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
03 Mar 2022
03 Mar 2022
Historique:
received:
06
10
2021
accepted:
24
01
2022
entrez:
4
3
2022
pubmed:
5
3
2022
medline:
8
3
2022
Statut:
epublish
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND
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
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
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
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.
Identifiants
pubmed: 35241040
doi: 10.1186/s12891-022-05100-7
pii: 10.1186/s12891-022-05100-7
pmc: PMC8892708
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
199Informations de copyright
© 2022. The Author(s).
Références
J Arthroplasty. 2021 Jul;36(7S):S351-S357
pubmed: 33487512
Arthroplast Today. 2018 Dec 05;5(1):26-31
pubmed: 31020017
Bone Joint J. 2014 Nov;96-B(11):1464-71
pubmed: 25371458
Hip Pelvis. 2020 Mar;32(1):11-16
pubmed: 32158724
J Arthroplasty. 2017 Jan;32(1):202-206
pubmed: 27449717
Int Orthop. 2018 Jan;42(1):191-196
pubmed: 29116356
J Orthop. 2017 Jan 10;14(1):216-222
pubmed: 28115800
Clin Orthop Relat Res. 2011 Apr;469(4):1188-96
pubmed: 20830542
Knee Surg Sports Traumatol Arthrosc. 2021 Oct;29(10):3287-3298
pubmed: 32671435
J Orthop Trauma. 2016 Sep;30(9):503-9
pubmed: 27078131
BMC Musculoskelet Disord. 2017 Apr 4;18(1):144
pubmed: 28376876
Bone Joint J. 2014 Dec;96-B(12):1649-56
pubmed: 25452368
Int Orthop. 2020 Apr;44(4):677-684
pubmed: 31392494
Knee. 2019 Oct;26(5):1080-1087
pubmed: 31420209
J Arthroplasty. 2020 May;35(5):1402-1406
pubmed: 31924488
Injury. 2018 Feb;49(2):392-397
pubmed: 29208310