Distal Femoral Replacement After Distal Femur Periprosthetic Fracture: A Case Report.

Distal femoral periprosthetic fractures present a complex challenge, particularly in elderly patients with comorbidities and poor bone quality. We report a case of a 62-year-old Saudi female with morbid obesity and a history of bilateral total knee arthroplasty (TKA) who sustained a distal femoral fracture after minor trauma. Due to limited bone stock and fracture proximity to the prosthesis, internal fixation was ruled out. The patient underwent successful revision TKA with distal femoral replacement (DFR). Postoperative recovery was good, and she was discharged on day 4 with a knee range of motion of 0-90°. This case underscores the viability of DFR as a limb-salvaging option, offering immediate weight-bearing and early mobilization.