High complication, mortality rates seen with total femoral replacement

Although the use of total femoral replacement in treating a periprosthetic femoral fracture offers good functional outcomes and strong implant survival, it has also been linked to high rates of complication and mortality, according to results of a recently published study.

Researchers analyzed 19 consecutive patients who underwent total femoral replacement (TFR) for salvage of a periprosthetic fracture between 2000 and 2010. Metrics evaluated included patient demographics, mobility information, both preoperative and postoperative SF-12 values, 1-year Toronto Extremity Salvage Score (TESS) values, and the quantity and nature of any postoperative complications.

Although the implant survival rate at 10 years postoperatively was 86%, the mortality rate during that span was 58%.

Postoperative complications were observed in 25% of patients. All 19 patients required either an intraoperative or postoperative blood transfusion. Admittance to the hospital high-dependency unit occurred with 17 patients.

The 1-year TESS value was 69%; however, 16 patients required a postoperative walking aid, whereas only five required such aid prefracture.

SF-12 values in prefracture physical (4.4) and mental (0.3) component values showed no significant differences with 1-year postoperative values, according to the researchers.

Disclosure: The authors have no relevant financial disclosures.


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Josh Sandberg

Josh Sandberg is the President and CEO of Ortho Spine Partners and sits on several company and industry related Boards. He also is the Creator and Editor of OrthoSpineNews.

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