Distal Femoral Arthroplasty for Management of Periprosthetic Supracondylar Fractures of the Femur

The incidence of periprosthetic supracondylar femoral fractures is 0.3% to 2.5% after primary total knee arthroplasty.

We performed a retrospective review 17 patients managed by distal femoral arthroplasty for periprosthetic supracondylar femoral fracture.

Mean age was 76 years (SD, 12.58). Mean follow-up was 33.9 months (SD, 10.57). Mean final range of motion was 2° of fixed flexion (SD, 5.3) and flexion of 90.2° (SD, 20.8). Mean final follow-up Knee Society Score was 67.15 (SD, 19.7). Mean Short Form–12 physical component was 36.57 (SD, 11.2), and mean Short Form–12 mental component was 42.64 (SD, 12.09). Four complications (4 patients) were managed successfully without revision of the prosthesis. Two failures (2 patients) required prosthesis revision: patellar maltracking with knee dislocation, and periprosthetric femoral fracture.

Distal femoral arthroplasty is a successful procedure. Complication rates are not insignificant, which is expected with the complexity of this clinical scenario.