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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-12-2020 | Periprosthetic Fracture | KNEE

Excellent mid-term osseointegration and implant survival using metaphyseal sleeves in revision total knee arthroplasty

Authors: Sebastian M. Klim, Florian Amerstorfer, Gerwin A. Bernhardt, Patrick Sadoghi, Georg Hauer, Lukas Leitner, Andreas Leithner, Mathias Glehr

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2020

Abstract

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.

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Title: Excellent mid-term osseointegration and implant survival using metaphyseal sleeves in revision total knee arthroplasty
Authors: Sebastian M. Klim
Florian Amerstorfer
Gerwin A. Bernhardt
Patrick Sadoghi
Georg Hauer
Lukas Leitner
Andreas Leithner
Mathias Glehr
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Periprosthetic Fracture
Bone Defect
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2020
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-020-05865-1

2024 ASCO Annual Meeting

Springer Medicine

Excellent mid-term osseointegration and implant survival using metaphyseal sleeves in revision total knee arthroplasty

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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