Study Analyzes Distal Femoral Replacement and Periprosthetic Joint Infection After Non-oncological Reconstruction

Hackensack University Medical Center Research Finds High Level of Complications, Reoperations and Failure

A study in The Journal of Arthroplasty offers an insightful retrospective analysis of distal femoral replacement (DFR) and periprosthetic joint infection after non-oncological reconstruction. The investigators, including Rothman Orthopaedic Institute surgeons and researchers affiliated with Hackensack Meridian Hackensack University Medical Center, determined that while DFR is a valuable reconstructive option for patients with massive bone loss around the knee, patients undergoing DFR are at high risk of complications, reoperations and failure.

The study focused specifically on DFR outcomes for 182 patients with aseptic failures, fractures and periprosthetic joint infection. Data was collected on indication, postoperative complications, reoperation, revision and follow-up. The overall postoperative complication rate was quite high at 36 percent, and the most common complication was periprosthetic joint infection, which affected 17 percent of patients.

Patients who had a prior periprosthetic joint infection had the lowest implant survivorship compared to patients undergoing DFR for management of periprosthetic fracture and mechanical loosening. The group with a prior periprosthetic joint infection also was at a fourfold increased risk of postoperative periprosthetic joint infection compared to individuals without a prior infection.

Revision-free DFR implant survivorship of the DFR implant was 91 percent at one year, 87 percent at two years, 82 percent at five years, and 73 percent at 10 years. The rate of reoperation for any cause was 29 percent, and the revision rate was 13 percent.

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