Good clinical and radiographic outcome of cementless metal metaphyseal sleeves in total knee arthroplasty
DOI:
https://doi.org/10.1080/17453674.2017.1398013Abstract
Background and purpose — The number of revision total knee arthroplasties (TKA) is continuously increasing, leading to a growing need for reliable management of metaphyseal bone loss. We evaluated patients operated with a TKA using metal metaphyseal sleeves for bone defects with a minimum 5-year follow-up. Patients and methods — 37 patients had been operated on. 3 patients died and 3 patients were lost during follow-up. Of the 31 remainders (20 women), 9 had been operated on with a primary TKA and 22 with a revision TKA at the index surgery. The mean age at surgery was 69 (54–89) years and the mean follow-up time was 7.4 (5–12) years. Bone defects were classified according to the Anderson Orthopaedic Research Institute classification (tibia: type I n = 9, type II n = 5 and type III n = 17; femur: type I n = 12, type II n = 3 and type III n = 16). Results — At final follow-up one-third experienced an improvement concerning walking aids and walking distance. Except for 1 patient, all had full extension and a mean knee flexion of 110 (90–140) degrees. VAS pain at rest was 13 (SD 25) and on movement 30 (SD 31). 7 patients were reoperated due to: infection (n = 4), periprosthetic fracture (n = 1), skin necrosis (n = 1), and wound rupture (n = 1). The cumulative 5-year survival rate for reoperation was 77% (CI 63–92) and for revision 97% (CI 91–100). At the time of final follow-up, the sleeves showed good osseointegration with no signs of progressive radiolucency or migration. Interpretation — Titanium sleeves are a promising option in managing difficult cases with metaphyseal bone defects in TKA, providing a stable construct with good medium-term radiographic outcomeDownloads
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Published
2018-01-02
How to Cite
Thorsell, M., Hedström, M., Wick, M. C., & Weiss, R. J. (2018). Good clinical and radiographic outcome of cementless metal metaphyseal sleeves in total knee arthroplasty. Acta Orthopaedica, 89(1), 84–88. https://doi.org/10.1080/17453674.2017.1398013
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Copyright (c) 2018 Martin Thorsell, Margareta Hedström, Marius C Wick, Rüdiger J Weiss
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Acta Orthopaedica (Scandinavica) content is available freely online as from volume 1, 1930. The journal owner owns the copyright for all material published until volume 80, 2009. As of June 2009, the journal has however been published fully Open Access, meaning the authors retain copyright to their work. As of June 2009, articles have been published under CC-BY-NC or CC-BY licenses, unless otherwise specified.