Role of long stem revision knee prosthesis in periprosthetic and complex distal femoral fractures: a review of eight patients.

Abstract

Eight patients, six with periprosthetic and two with complex distal femoral fractures (one pathological, and one with failed internal fixation) were treated with a cemented long stem revision arthroplasty prosthesis to address the issues of articular comminution, stability, alignment and early mobilisation. The average age of the patients was 78 years (range 39-81). There were no intra-operative complications. The mean hospital stay was 12 days (range 8-21). Post-operative complications included one case of posterior dislocation and one superficial infection. All patients had remarkable symptomatic relief at 3 months as indicated by the visual analogue scores. All periprosthetic fractures achieved bony union at a mean time of 3.8 months. The mean follow up was 24 months (range 14-42). The American Knee Society score revealed one 'excellent', five 'good', one 'satisfactory' and one 'poor' result. The mean loss of extension was 7.7 degrees (range 5 degrees -15 degrees ) and the mean flexion achieved was 66 degrees (range: 15 degrees to 85 degrees ). The mean alignment was 6 degrees (range 0 degrees -10 degrees ) valgus. This study highlights the role of long stem prosthesis in periprosthetic and some complex distal femoral fractures in offering stability and early mobilisation.