Abstract
Endoprosthetic replacement (EPR) is an available option for the management of massive bone loss around failed knee implants. The aim of this study was to determine the results of knee EPRs performed for non-tumour indications. Since 2007, 85 EPRs were performed for in a single tertiary centre by seven surgeons. Mean age at surgery was 73.5 years (range:35–95) with infection as the most common indication (49%), followed by aseptic loosening (18%), complex primary replacement (16%), fracture (15%) and mechanical failure (2%). Mean follow up was 4 years (range:1–9). Functional outcome was determined using the Oxford Knee Score (OKS). At follow-up, 21 patients were deceased and 2 lost to follow-up. Complication rate was 19%. Of the 7 infected cases, 6 were treated with DAIR (debridement, antibiotics, and implant retention) and one underwent above knee amputation. Four of the patients undergoing DAIR were cleared of infection and 2 are on long-term antibiotics. Accounting for implant revision, loss to follow-up and those on long-term antibiotics as failures, 5-year survival was 89% with an average OKS of 25 (SD=10). This mid-term study shows that distal femur EPR is a valuable option for the increasing burden of complex revision knee surgery
