Observational studyKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022
Revision TKA with a distal femoral replacement is at high risk of reinfection after two-stage exchange for periprosthetic knee joint infection.
Observational study in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 32 citations in OpenAlex.
- Revision-Free Survival After MUTARS Total Knee Reconstruction in Limb Salvage Surgery: Primary Implantation Versus Conversion.Cancers · 2026Article
- Chronic infections of knee megaprostheses: are "Off-Label" DAIR-Plus or partial two-stage exchange viable options?Archives of orthopaedic and trauma surgery · 2026Article
- Revision knee arthroplasty with distal femoral replacement : single center study.Archives of orthopaedic and trauma surgery · 2025Article
- Modular megaprostheses yield high any-type failure rate but acceptable infection control rate in patients with chronic hip and knee periprosthetic joint infection and severe bone loss: a single-center experience.Journal of bone and joint infection · 2025Article
- Joint preservation in revision arthroplasty and intercalary tumour implants using custom stem solutions.BMC musculoskeletal disorders · 2024Article
- Management of Bone Loss in Revision Total Knee Arthroplasty: An International Consensus Symposium.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2024Review
- Surgical Management of Periprosthetic Joint Infections in Hip and Knee Megaprostheses.Medicina (Kaunas, Lithuania) · 2024Review
- Evaluation of time to reimplantation as a risk factor in two-stage revision with static spacers for periprosthetic knee joint infection.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Article
- Comparative Functional and Isokinetic Analysis between Implants with Posterior Stabilization and Rotating Hinge Total Knee Arthroplasty.Revista brasileira de ortopedia · 2024Article
- Silver-Coated Distal Femur Megaprosthesis in Chronic Infections with Severe Bone Loss: A Multicentre Case Series.Journal of clinical medicine · 2023Article
- Good Mid-Term Implant Survival of a Novel Single-Design Rotating-Hinge Total Knee Arthroplasty.Journal of clinical medicine · 2023Article
- Custom-Made Metaphyseal Sleeves in "Beyond" AORI III Defects for Revision Knee Arthroplasty-Proof of Concept and Short-Term Results of a New Technique.Journal of personalized medicine · 2023Article
- Megaprosthesis in Non-Oncologic Settings-A Systematic Review of the Literature.Journal of clinical medicine · 2023Review
- The Role of Single Positive Cultures in Presumed Aseptic Total Hip and Knee Revision Surgery-A Systematic Review of the Literature.Diagnostics (Basel, Switzerland) · 2023Review
- Is long time to reimplantation a risk factor for reinfection in two-stage revision for periprosthetic infection? A systematic review of the literature.Frontiers in surgery · 2023Review
- Survivorship, complications, and outcomes following distal femoral arthroplasty for non-neoplastic indications.Bone & joint open · 2022Article
- Biomechanical Comparison Between Porous Ti6Al4V Block and Tumor Prosthesis UHMWPE Block for the Treatment of Distal Femur Bone Defects.Frontiers in bioengineering and biotechnology · 2022Article
- Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMegaprosthetic distal femoral reconstruction (DFR) is a limb-salvage procedure to address bone loss following two-stage revision for periprosthetic knee joint infection (PJI). The purpose of this study was to analyze the survival of DFR compared to hinged total knee arthroplasty (TKA). It was hypothesized that DFR was associated with a poorer survival.
methodsIn this retrospective single-center study, 97 subjects who underwent two-stage revision of chronic knee PJI were included. Among these, 41 were DFR. The diagnosis of PJI was established using the Musculoskeletal Infection Society (MSIS) criteria. Implant survival was calculated using Kaplan-Meier method and compared with the log-rank test as well as multivariate Cox regression at a minimum follow-up period of 24 months.
resultsThe median follow-up period was 59 (interquartile range (IQR) 45-78) months. Overall, 24% (23/97) of patients required revision surgery for infection. The infection-free survival of rotating hinge revision TKA was 93% (95% Confidence Interval (CI) 86-100%) at five years compared to 50% (95% CI 34-66%) for DFR. In multivariate analysis, the risk factors for reinfection were DFR reconstruction (HR 4.7 (95% CI 1-22), p = 0.048), length of megaprosthesis (HR 1.006 (95% CI 1.001-1.012), p = 0.032) and higher BMI (HR 1.066, 95% CI 1.018-1.116), p = 0.007). 10% (4/41) of patients undergoing DFR underwent amputation to treat recurrent infection.
conclusionMegaprosthetic DFR as part of a two-stage exchange for PJI is a salvage treatment that has a high risk for reinfection compared to non-megaprosthetic TKA. Patients must therefore be counseled accordingly. LEVEL OF EVIDENCE: Retrospective observational study, Level IV.
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