Open AccessExcellent mid‐term osseointegration and implant survival using metaphyseal sleeves in revision total knee arthroplasty
Author(s) -
Klim Sebastian M.,
Amerstorfer Florian,
Bernhardt Gerwin A.,
Sadoghi Patrick,
Hauer Georg,
Leitner Lukas,
Leithner Andreas,
Glehr Mathias
Publication year - 2020
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-020-05865-1
Subject(s) - medicine , osseointegration , womac , radiological weapon , radiography , fixation (population genetics) , aseptic processing , implant , surgery , osteoarthritis , dentistry , orthopedic surgery , oxford knee score , orthodontics , population , alternative medicine , environmental health , pathology
Purpose Metaphyseal fixation in revision total knee arthroplasty (RTKA) is a very promising treatment option for extended bone defects. Currently published mid‐term results remain limited. The purpose was to analyse the implant durability, the clinical and the radiological mid‐term results in RTKA when using metaphyseal sleeves. Methods Clinical and radiological follow‐up examinations were performed in 92 patients (93 knees) with RTKA using hybrid fixation technique (cementless sleeves and stem). Radiographic measurements regarding osseointegration at the bone–sleeve interface were performed and the range of motion (ROM), a subjective satisfaction score (SSS), the American Knee Society Score (KSS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as well as the SF‐36 Health survey were examined. Bone defects were analysed using the Anderson Orthopaedic Research Institute (AORI) classification. Results No knee had to be revised due to aseptic loosening at the time of the follow‐up (mean 6.3 years ± 2.3, minimum 2 years). Satisfactory radiographic osseointegration at the sleeve/bone interface was detected in 96.1% of cases. 17 knees (18.2%) had to be re‐revised, 15 of them due to a recurrent infection and 2 due to aseptic reasons (mediolateral instability and a periprosthetic fracture). The median of the ROM (96°), SSS (8), KSS (87), WOMAC (9), SF‐36 MCS (55) and SF‐36 PCS (38) showed very satisfying results. Conclusion No case of aseptic loosening was found in this large series of RTKA with extended bone defects using metaphyseal sleeve fixation. In this large retrospective series, it has been shown that this technique is an excellent treatment option for extended bone defects in RTKA surgery. Level of evidence Retrospective cohort study, level III.