Published in:
Open Access 01-03-2013 | Symposium: Papers Presented at the 2011 ISOLS Meeting in Beijing, China
Compress® Knee Arthroplasty Has 80% 10-year Survivorship and Novel Forms of Bone Failure
Published in: Clinical Orthopaedics and Related Research® | Issue 3/2013
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Background
Compliant, self-adjusting compression technology is a novel approach for durable prosthetic fixation of the knee. However, the long-term survival of these constructs is unknown.
Questions/purposes
We therefore determined the survival of the Compress® prosthesis (Biomet Inc, Warsaw, IN, USA) at 5 and 10 actuarial years and identified the failure modes for this form of prosthetic fixation.
Methods
We retrospectively reviewed clinical and radiographic records for all 82 patients who underwent Compress® knee arthroplasty from 1998 to 2008, as well as one patient who received the device elsewhere but was followed at our institution. Prosthesis survivorship and modes of failure were determined. Followup was for a minimum of 12 months or until implant removal (median, 43 months; range, 6–131 months); 28 patients were followed for more than 5 years.
Results
We found a survivorship of 85% at 5 years and 80% at 10 years. Eight patients required prosthetic revision after interface failure due to aseptic loosening alone (n = 3) or aseptic loosening with periprosthetic fracture (n = 5). Additionally, five periprosthetic bone failures occurred that did not require revision: three patients had periprosthetic bone failure without fixation compromise and two exhibited irregular prosthetic osteointegration patterns with concomitant fracture due to mechanical insufficiency.
Conclusions
Compress® prosthetic fixation after distal femoral tumor resection exhibits long-term survivorship. Implant failure was associated with patient nonadherence to the recommended weightbearing proscription or with bone necrosis and fracture. We conclude this is the most durable FDA-approved fixation method for distal femoral megaprostheses.
Level of Evidence
Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.