Clinical outcomes of cemented distal femur replacements with all-polyethylene tibial components for oncologic indications

Figure 1 Radiographs of a 28-year-old male patient demonstrating a pathologic fracture of the distal third of the left femoral diaphysis. A: Preoperative anteroposterior and lateral radiographs prior to reconstruction; B: Following left distal femoral replacement with use of an all-polyethylene tibial component.

Figure 2 Competing risk analysis for cemented distal femoral replacement with all-polyethylene tibial component constructs for oncologic indications with all-cause revision (femoral or tibial component) and all-cause reoperation as the primary endpoints. One- and three-year cumulative incidences were 14.6% (95%CI 5.7%-27.4%) and 24.0% (95%CI 9.9%-41.4%), respectively, with all-cause revision as the endpoint. One- and three-year cumulative incidences were 26.1% (95%CI 14.2%-39.7%) and 47.2% (95%CI 27.5%-64.5%), respectively, with all-cause reoperation as the endpoint. DFR: Distal femoral replacement.

Figure 3 Competing risk analysis for cemented distal femoral replacement with all-polyethylene tibial components for oncologic indications with all-cause revision of the all-polyethylene tibial component (APT) and revision of the APT due to periprosthetic joint infection as the primary endpoints. One- and three-year cumulative incidences were 18.2% (95%CI 2.5%-45.5%) and 47.0% (95%CI 15.1%-74.0%), respectively, with all-cause revision of the APT as the endpoint. One- and three-year cumulative incidences were 10.0% (95%CI 0.5%-37.4%) and 44.0% (95%CI 6.3%-59.3%), respectively, with revision of APT due to periprosthetic joint infection as the endpoint. APT: All-polyethylene tibial; PJI: Periprosthetic joint infection.

Figure 4 Radiographs of a 58-year-old male patient showing increased lucency surrounding the proximal femoral stem with abutment of the lateral cortex. A: Anteroposterior radiographs of the loosened distal femoral replacement; B: Interval explantation of the prior distal femoral replacement and placement of an intercalary cemented modular antibiotic spacer.