Comparison of locking compression plate and distal femoral replacement for periprosthetic distal femoral fractures: a retrospective study

Objective To compare the clinical outcomes of locking compression plate (LCP) and distal femoral replacement (DFR) for periprosthetic distal femoral fractures (PDFFs) after total knee arthroplasty. Methods This retrospective study identified patients with PDFFs in an institutional database between January 2012 and December 2021. Demographic data and clinical outcomes, including postoperative complications, reoperation, 1-year mortality, Knee Society Scores (KSS) and Knee Society Functional Score (KSFS) were analysed. Results In total, 12 patients treated with LCP and six patients treated with DFR were included. There was no significant difference between the LCP and DFR groups in terms of postoperative complications (25.0% versus 33.3%, respectively), reoperation (8.3% versus 0.0%), respectively, 1-year mortality (8.3% versus 16.7%, respectively) or mean +/- SD KSS (80.3 +/- 8.3 versus 78.0 +/- 2.5, respectively). However, the mean +/- SD KSFS was significantly better for patients with LCP than for those with DFR (51.8 +/- 12.5 versus 37.0 +/- 6.7, respectively). Conclusion DFR provides similar clinical outcomes compared with LCP for PDFFs. Patients with advanced age may benefit from DFR to allow early weight bearing.