Abstract：
OBJECTIVE: The aim of this study was to investigate the rate of revision for distal femoral arthroplasty (DFA) performed as a primary procedure for native knee fractures using data from the Australian Orthopaedic Association National Joint Arthroplasty Registry (AOANJRR).
METHODS: Data from the AOANJRR were obtained for DFA performed as primary procedures for native knee fractures from 1 September 1999 to 31 December 2020. Pathological fractures and revision for failed internal fixation were excluded. The five prostheses identified were the Global Modular Arthroplasty System, the Modular Arthroplasty System, the Modular Universal Tumour And Revision System, the Orthopaedic Salvage System, and the Segmental System. Patient demographic data (age, sex, and American Society of Anesthesiologists grade) were obtained, where available. Kaplan-Meier estimates of survival were used to determine the rate of revision, and the reasons for revision and mortality data were examined.
RESULTS: The AOANJRR identified 153 primary DFAs performed for native knee fractures in 151 patients during the study period, with 63.3% of these (n = 97) performed within the last five years. The median follow-up was 2.1 years (interquartile range 0.8 to 4.4). The patient population was 84.8% female (n = 128), with a mean age of 76.1 years (SD 11.9). The cumulative percent revision rate at three years was 10%. The most common reason for revision was loosening, followed by infection. Patient survival at one year was 87.5%, decreasing to 72.8% at three years postoperatively.
CONCLUSIONS: The use of DFA to treat native knee fractures is increasing, with 63.3% of cases performed within the last five years. While long-term data are not available, the results of this study suggest that DFA may be a reasonable option for elderly patients with native knee fractures where fixation is not feasible, or for whom prolonged non-weightbearing may be detrimental. Cite this article: Bone Joint J 2022;104-B(7):894-901.
METHODS: Data from the AOANJRR were obtained for DFA performed as primary procedures for native knee fractures from 1 September 1999 to 31 December 2020. Pathological fractures and revision for failed internal fixation were excluded. The five prostheses identified were the Global Modular Arthroplasty System, the Modular Arthroplasty System, the Modular Universal Tumour And Revision System, the Orthopaedic Salvage System, and the Segmental System. Patient demographic data (age, sex, and American Society of Anesthesiologists grade) were obtained, where available. Kaplan-Meier estimates of survival were used to determine the rate of revision, and the reasons for revision and mortality data were examined.
RESULTS: The AOANJRR identified 153 primary DFAs performed for native knee fractures in 151 patients during the study period, with 63.3% of these (n = 97) performed within the last five years. The median follow-up was 2.1 years (interquartile range 0.8 to 4.4). The patient population was 84.8% female (n = 128), with a mean age of 76.1 years (SD 11.9). The cumulative percent revision rate at three years was 10%. The most common reason for revision was loosening, followed by infection. Patient survival at one year was 87.5%, decreasing to 72.8% at three years postoperatively.
CONCLUSIONS: The use of DFA to treat native knee fractures is increasing, with 63.3% of cases performed within the last five years. While long-term data are not available, the results of this study suggest that DFA may be a reasonable option for elderly patients with native knee fractures where fixation is not feasible, or for whom prolonged non-weightbearing may be detrimental. Cite this article: Bone Joint J 2022;104-B(7):894-901.
摘要：
目的：本研究的目的是利用澳大利亚矫形外科协会国家关节置换术登记处（AOANJRR）的数据，调查作为天然膝关节骨折的主要手术进行的远端股骨置换术（DFA）的翻修率。
方法：来自AOANJRR的数据来自1999年9月1日至2020年12月31日作为天然膝关节骨折的主要手术进行的DFA。排除病理性骨折和内固定失败的翻修。确定的五个假体是全球模块化关节成形术系统，模块化关节成形术系统，模块化通用肿瘤和修订系统，骨科抢救系统,和分段系统。患者人口统计数据(年龄，性别,和美国麻醉医师协会等级)获得，可用的地方。生存率的Kaplan-Meier估计用于确定修正率，并检查了修订原因和死亡率数据.
结果：在研究期间，AOANJRR确定了151例患者中用于天然膝关节骨折的153例原发性DFAs，其中63.3%(n=97)在过去五年内完成。中位随访时间为2.1年（四分位数范围0.8至4.4）。患者为84.8%女性（n=128），平均年龄76.1岁（SD11.9）。三年的累积百分比修订率为10%。修订的最常见原因是松动，其次是感染。患者一年生存率为87.5%，术后三年降至72.8%。
结论：使用DFA治疗天然膝关节骨折正在增加，63.3%的病例在过去五年内完成。虽然没有长期数据，这项研究的结果表明，DFA可能是一个合理的选择，对于固定不可行的天然膝关节骨折的老年患者，或者长时间不负重可能对他们有害。引用本文：骨关节J2022；104-B（7）：894-901。
方法：来自AOANJRR的数据来自1999年9月1日至2020年12月31日作为天然膝关节骨折的主要手术进行的DFA。排除病理性骨折和内固定失败的翻修。确定的五个假体是全球模块化关节成形术系统，模块化关节成形术系统，模块化通用肿瘤和修订系统，骨科抢救系统,和分段系统。患者人口统计数据(年龄，性别,和美国麻醉医师协会等级)获得，可用的地方。生存率的Kaplan-Meier估计用于确定修正率，并检查了修订原因和死亡率数据.
结果：在研究期间，AOANJRR确定了151例患者中用于天然膝关节骨折的153例原发性DFAs，其中63.3%(n=97)在过去五年内完成。中位随访时间为2.1年（四分位数范围0.8至4.4）。患者为84.8%女性（n=128），平均年龄76.1岁（SD11.9）。三年的累积百分比修订率为10%。修订的最常见原因是松动，其次是感染。患者一年生存率为87.5%，术后三年降至72.8%。
结论：使用DFA治疗天然膝关节骨折正在增加，63.3%的病例在过去五年内完成。虽然没有长期数据，这项研究的结果表明，DFA可能是一个合理的选择，对于固定不可行的天然膝关节骨折的老年患者，或者长时间不负重可能对他们有害。引用本文：骨关节J2022；104-B（7）：894-901。
