ArticleArthroplasty today2026
Primary Versus Salvage Distal Femoral Endoprosthetic Replacement Following Native Distal Femur Fracture: A Systematic Review and Meta-Analysis.
Article in Arthroplasty today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Surgical management of native distal femoral fractures (DFFs) in elderly patients includes open reduction and internal fixation (ORIF) or distal femoral endoprosthetic replacement (DFR). When ORIF is complicated by nonunion or fixation failure, salvage DFR (sDFR) may be required. The comparative outcomes of primary DFR (pDFR) vs sDFR remain unclear. This systematic review and meta-analysis aimed to assess the quality of published literature and compared clinical and functional outcomes between pDFR and sDFR for native DFFs. Methods: MEDLINE, Embase, and Cochrane databases were searched from inception to April 2024. Studies investigating outcomes of pDFR or sDFR following native DFFs were included. Studies evaluating periprosthetic fractures, oncologic indications, or primary arthritis were excluded. Twelve studies comprising 281 patients (230 pDFR, 51 sDFR) were included. Results: Patients undergoing pDFR were significantly older (mean 79.3 vs 64.9 years; Conclusions: sDFR following failed fixation of native DFFs was associated with nearly twice the risk of reoperation and postoperative complications compared to pDFR, despite being performed in a younger and less comorbid cohort. Elderly patients at risk of fixation failure may therefore benefit from pDFR.
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Registered trials
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