Knee Mega-Prosthesis in the Management of Complex Knee Fracture of the Elderly a Case Series and Review of the Literature

Purpose: the goal of this paper is to share our experience with the use of mega knee-prosthesis as a treatment option for complex DFF in the elderly patient and do a review the literature.  Methods: we operated 4 patients with complex DFF using a mega knee-prosthesis. All patients were operated by one senior surgeon. No patients were lost at follow-up. One patient died 7 months after the surgery from flu. All patient were female and the average age at the time of the surgery was 79, 5. Clinical outcomes were measured through the WOMAC, Oxford knee score and pain NRS. Post-operative autonomy was measured using the Parker score. A follow-up radiographic analysis was performed independently by the surgeon and a radiologist. Results: At an average follow-up of 2,3 years (range, 0,6 to 4,2 years), the average Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) was 17,25 (range, 7 to 37), the average Oxford knee score was 35,25 (range, 25 to 41) and the average pain Numerical Rating Scale (NRS) was 0,5 (range, 0 to 1). Conclusion: The use of cemented knee mega-prosthesis for complex intra-articular distal femoral fractures is a viable treatment option in elderly patient with osteoporotic bone as it allows immediate full weight bearing and a rapid return to pre-operative functional status.