Abstract. Introduction. Patients presenting with loosening or a fracture between ipsilateral hip and knee replacements provide a unique reconstructive challenge. We present mid-term results of the cement-over megaprosthesis (COM) when managing these complex cases. A COM is cement-linked to the stem of a well-fixed existing implant. We report the largest series to date and show that this may be preferable to total femoral replacement in a cohort of patients who often have significant co-morbidities. Methodology. A retrospective analysis of patients undergoing COM between 2002–2022 was performed. Primary outcomes were defined as implant survival, displayed with survival analysis. Secondary outcomes included mortality and surgical complications. Functional outcomes included Visual Analogue Score (VAS), EuroQol-5D-3L and Musculoskeletal Tumour Society (MSTS) score at one year post operatively. Results. 34 patients underwent reconstructive cement-over technique. There were 20 custom distal femur replacements and 10 custom proximal femoral replacements. Two patients were revised, with a ten year implant survival of 94%. Fifteen patients died during the study period with an mean time to death of 66 months (25–109). The mean follow up was 75 months. 11 patients (32%) developed surgical complications. Mean VAS score was 4.9 (1–10), EuroQol-5D-3L index 0.45 (−0.59 – 0.88) and MSTS score was 16.8 (2–27) in 29 patients. Conclusion. The COM technique provides good implant survivorship in complex cases with compromised bone stock and this series confirms this as an established alternative to total femoral replacement in these cases

Aims

Periprosthetic fractures (PPFs) around the knee are challenging injuries. This study aims to describe the characteristics of knee PPFs and the impact of patient demographics, fracture types, and management modalities on in-hospital mortality.

Aims

Since redesign of the Oxford phase III mobile-bearing unicompartmental knee arthroplasty (UKA) femoral component to a twin-peg design, there has not been a direct comparison to total knee arthroplasty (TKA). Thus, we explored differences between the two cohorts.

We present detailed information about early morbidity after aseptic revision knee replacement from a nationwide study. All aseptic revision knee replacements undertaken between 1st October 2009 and 30th September 2011 were analysed using the Danish National Patient Registry with additional information from the Danish Knee Arthroplasty Registry. The 1218 revisions involving 1165 patients were subdivided into total revisions, large partial revisions, partial revisions and revisions of unicondylar replacements (UKR revisions). The mean age was 65.0 years (27 to 94) and the median length of hospital stay was four days (interquartile range: 3 to 5), with a 90 days re-admission rate of 9.9%, re-operation rate of 3.5% and mortality rate of 0.2%. The age ranges of 51 to 55 years (p = 0.018), 76 to 80 years (p < 0.001) and ≥ 81 years (p < 0.001) were related to an increased risk of re-admission. The age ranges of 76 to 80 years (p = 0.018) and the large partial revision subgroup (p = 0.073) were related to an increased risk of re-operation. The ages from 76 to 80 years (p < 0.001), age ≥ 81 years (p < 0.001) and surgical time > 120 min (p <  0.001) were related to increased length of hospital stay, whereas the use of a tourniquet (p = 0.008) and surgery in a low volume centre (p = 0.013) were related to shorter length of stay.

In conclusion, we found a similar incidence of early post-operative morbidity after aseptic knee revisions as has been reported after primary procedures. This suggests that a length of hospital stay ≤ four days and discharge home at that time is safe following aseptic knee revision surgery in Denmark.

Cite this article: Bone Joint J 2014;96-B:1649–56.