Distal Femoral Replacement Following an Intraoperative Periprosthetic Fracture in a Patient with Prior Bone Mulch ACL Reconstruction

Periprosthetic distal femur fractures can be treated nonoperatively, with open reduction and internal fixation or with more constrained prostheses. Distal femoral replacement is typically a last resort treatment option for comminuted periprosthetic or osteoporotic distal femoral fractures in patients with poor bone stock or resistant nonunions. We report the case of a 54-year-old female with a remote history of bone mulch ACL reconstruction who sustained an intraoperative comminuted bicondylar distal femur fracture during a primary total knee arthroplasty. This patient was treated with a distal femoral replacement and successfully returned to her preoperative function.