Knee. 2026 Feb 2;60:104350. doi: 10.1016/j.knee.2026.104350. Online ahead of print.
ABSTRACT
BACKGROUND: Total knee arthroplasty (TKA) and distal femoral replacement (DFR) can be used in limb-salvage after resection of bony tumors, but few reports have examined patient-reported outcome measurements (PROMs) with survival data in young patients. This study analyzed individuals who underwent TKA/DFR for neoplasm at a young (≤40) age, to report outcomes and survival experience.
METHODS: A retrospective study on 12 TKAs/23 DFRs was conducted between January 1990-2020 in 35 patients ≤40 years old. Electronic medical records were reviewed to identify patients with neoplasm, and collect data. Patients were contacted to obtain PROMs.
RESULTS: The median age (interquartile range) at surgery for TKAs and DFRs was 26.7 (22.7-34.0) and 24.6 years (20.9-28.4), respectively. Median follow-up was 3.95 (0.33-8.14) and 3.01 years (1.72-6.07). TKAs were more commonly due to complications after allograft reconstruction (75.0% vs. 0.00%, p < 0.0001), had lower blood loss (250 vs. 800 ml, p = 0.01) and a higher rate of tourniquet use (75.0% vs. 34.8%, p = 0.04). Revision-free survival (8-year) was 54.7% (95% confidence interval (CI): 13.7%-83.3%) for TKAs and 37.9% (95% CI: 10.4%-66.0%, p = 0.12) for DFRs. For TKAs, median KOOS Jr. was 76.3 (76.3-79.9), VR-12-Physical was 50.0 (40.5-51.7), VR-12-Mental was 40.8 (32.6-45.8), LEAS was 12.0 (12.0-13.0), and FJS was 23.0 (19.0-25.0), without statistical difference from the DFR group.
CONCLUSION: Patients ≤40 years old who underwent TKAs/DFRs for neoplastic disease demonstrated a similarly high postoperative complication rate and poor long-term survival. Almost all PROMs were favorable, reflecting a more promising postoperative experience than survival curves might demonstrate.
PMID:41632986 | DOI:10.1016/j.knee.2026.104350
