Distal femoral replacement - Does length matter? Mid-term results for distal femoral replacements.

Dhawan, Rohit; Spencer Jones, Richard; Cool, Paul

Abstract

BACKGROUND: Review of mid-term results (five years) for tumour and revision arthroplasty surgery using the Stanmore METS® distal femoral replacement.

METHODS: Data were collected retrospectively for 90 patients for procedures performed between 2002 and 2019. Kaplan-Meier survivorship for implant was estimated at five years post-op. Endpoints for survivorship analysis included revision for any cause and as per Henderson classification. Log rank test was used to compare implant survival for different categorical variables. Musculo-Skeletal Tumour Society (MSTS) score was used to estimate function.

RESULTS: Overall implant survival at five years was 76% (95% CI 66-86). Implants with a short body (<= 45 mm) had significantly better implant survival [87% (95% CI 78-99)] compared to those with larger bodies [63% (95% CI 48-82)] (logrank test, p = 0.031). There was no significant difference in implant survival for tumour and revision arthroplasty patients (logrank test, p = 0.61). Mean MSTS scores (median follow-up = 3.5 years) for tumour and revision arthroplasty patient were 71% and 63% respectively (Wilcoxon rank test, p < 0.05). Higher total number of surgeries was a significant predictor of patient mortality [HR = 0.7 (95% CI 0.49-0.99)]. Longer bodies were a significant predictor of implant failure [HR = 3.2 (95% CI 1.05-10.53), p < 0.05].

CONCLUSION: Overall outcome of Stanmore METS® distal femoral replacement at five years following tumour and revision arthroplasty reconstruction is comparable to the other implants.

Citation

Dhawan, R., Spencer Jones, R., & Cool, P. (2021). Distal femoral replacement - Does length matter? Mid-term results for distal femoral replacements. Knee, 31, 97 - 109. https://doi.org/10.1016/j.knee.2021.05.008

• Journal Article Type: Article
• Acceptance Date: May 18, 2021
• Online Publication Date: Jun 14, 2021
• Publication Date: 2021-08
• Journal: The Knee
• Print ISSN: 0968-0160
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 31
• Pages: 97 - 109
• DOI: https://doi.org/10.1016/j.knee.2021.05.008
• Keywords: Distal femoral replacement, Revision knee surgery, Tumour surgery, Kaplan meier survival, Infection
• Publisher URL: https://www.thekneejournal.com/article/S0968-0160(21)00145-9/fulltext#articleInformation