Distal femoral replacement using a hinged construct with postoperative posterior dislocation: a case series.

Abstract

Distal femoral replacement (DFR) with a rotating hinged prosthesis (RH) is sometimes used as a salvage procedure following complications related to total knee arthroplasty (TKA). This was a retrospective case series performed at a tertiary academic medical center from 2008 to 2023. Patients that are age 18-70, male or female, who underwent DFR-RH who experienced a jump post type dislocation event postoperatively were included in this study. Patient demographics, comorbidities, surgical data, additional surgeries, and postoperative outcomes were reviewed and recorded. In total, four patients were analyzed as part of this case study. All four patients were men, and all suffered posterior prosthetic dislocations. Three of the four patients went on to above knee amputation (AKA). Rates of postoperative DFR dislocation are low, and posterior dislocation was the most common direction in this series. Postoperative DFR dislocations may be more likely in obese males with significant surgical history to the dislocated limb.