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

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.

Acceptance Date May 18, 2021
Publication Date Jun 10, 2021
Journal The Knee
Print ISSN 1873-5800
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