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Erschienen in:

10.01.2022 | KNEE

Similar patient-reported outcomes for hybrid and cemented stem fixation for aseptic tibial revision total knee arthroplasty: a comparison of sequential prospective cohorts

verfasst von: Francisco A. Miralles-Muñoz, Matias Ruiz-Lozano, Adolfo Perez-Aznar, Emilio Sebastia-Forcada, Alejandro Lizaur-Utrilla, M. Flores Vizcaya-Moreno

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 12/2022

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Abstract

Purpose

The tibial stem fixation in an aseptic revision of total knee arthroplasty is poorly studied and controversial. The objective of this study was to prospectively compare clinical outcomes between hybrid and cemented fixation of the stem in aseptic tibial revision after a minimum follow-up of 5 years.

Methods

Two sequential prospective cohorts of patients who underwent aseptic tibial revision were compared after a minimum follow-up of five years: 31 had both tibial tray and stem cemented (cemented group), and 42 had a hybrid fixation with tibial tray cemented and stem cementless (hybrid group). Clinical assessment was performed by the Knee Society Scores and reduced Western Ontario and McMaster Universities Arthritis Index. Radiological assessment was also performed.

Results

There were no significant differences in preoperative data between groups. Postoperatively, no significant differences between groups in clinical scores or complication rate were found. Survival of the TKA revision at 5-year was 94% (95% CI 89–98%) in the cemented group, and 98% (95% CI 92–100%) in the hybrid group (ns).

Conclusion

Clinical outcomes and implant survival were comparable between hybrid and cemented tibial stem fixation.

Level of evidence

II.
Literatur
1.
Zurück zum Zitat Barrack RL, Stanley T, Burt M, Hopkins S (2004) The effect of stem design on end-of-stem pain in revision total knee arthroplasty. J Arthroplasty 19:119–124CrossRefPubMed Barrack RL, Stanley T, Burt M, Hopkins S (2004) The effect of stem design on end-of-stem pain in revision total knee arthroplasty. J Arthroplasty 19:119–124CrossRefPubMed
2.
Zurück zum Zitat Beckmann J, Luring C, Springorum R, Kock FX, Grifka J, Tingart M (2011) Fixation of revision TKA: a review of the literature. Knee Surg Sports Traumatol Arthrosc 19:872–879CrossRefPubMed Beckmann J, Luring C, Springorum R, Kock FX, Grifka J, Tingart M (2011) Fixation of revision TKA: a review of the literature. Knee Surg Sports Traumatol Arthrosc 19:872–879CrossRefPubMed
3.
Zurück zum Zitat Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47:1245–1251CrossRefPubMed Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47:1245–1251CrossRefPubMed
4.
Zurück zum Zitat Chon JG, Lombardi AV Jr, Berend KR (2004) Hybrid stem fixation in revision total knee arthroplasty (TKA). Surg Technol Int 12:214–220PubMed Chon JG, Lombardi AV Jr, Berend KR (2004) Hybrid stem fixation in revision total knee arthroplasty (TKA). Surg Technol Int 12:214–220PubMed
5.
Zurück zum Zitat Cintra FF, Yepéz AK, Rasga MG, Abagge M, Alencar PG (2015) Tibial component in revision of total knee arthroplasty: comparison between cemented and hybrid fixation. Rev Bras Ortop 46:585–590CrossRefPubMedPubMedCentral Cintra FF, Yepéz AK, Rasga MG, Abagge M, Alencar PG (2015) Tibial component in revision of total knee arthroplasty: comparison between cemented and hybrid fixation. Rev Bras Ortop 46:585–590CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Conditt MA, Parsley BS, Alexander JW, Doherty SD, Noble PC (2004) The optimal strategy for stable tibial fixation in revision total knee arthroplasty. J Arthroplasty 19(7 Suppl 2):113–118CrossRefPubMed Conditt MA, Parsley BS, Alexander JW, Doherty SD, Noble PC (2004) The optimal strategy for stable tibial fixation in revision total knee arthroplasty. J Arthroplasty 19(7 Suppl 2):113–118CrossRefPubMed
7.
Zurück zum Zitat Driesman AS, Macaulay W, Schwarzkopf R (1999) Cemented versus cementless stems in revision total knee arthroplasty. J Knee Surg 32:704–709 Driesman AS, Macaulay W, Schwarzkopf R (1999) Cemented versus cementless stems in revision total knee arthroplasty. J Knee Surg 32:704–709
8.
Zurück zum Zitat Engh GA, Ammeen DJ (1999) Bone loss with revision total knee arthroplasty: defect classification and alternatives for reconstruction. Instr Course Lect 48:167–175PubMed Engh GA, Ammeen DJ (1999) Bone loss with revision total knee arthroplasty: defect classification and alternatives for reconstruction. Instr Course Lect 48:167–175PubMed
9.
Zurück zum Zitat Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 48:9–12 Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 48:9–12
10.
Zurück zum Zitat Fehring TK, Odum S, Olekson C, Griffin WL, Mason JB, McCoy TH (2003) Stem fixation in revision total knee arthroplasty: a comparative analysis. Clin Orthop Relat Res 416:217–224CrossRef Fehring TK, Odum S, Olekson C, Griffin WL, Mason JB, McCoy TH (2003) Stem fixation in revision total knee arthroplasty: a comparative analysis. Clin Orthop Relat Res 416:217–224CrossRef
11.
Zurück zum Zitat Fleischman AN, Azboy I, Fuery M, Restrepo C, Shao H, Parvizi J (2017) Effect of stem size and fixation method on mechanical failure after revision total knee arthroplasty. J Arthroplasty 32(9S):202–208CrossRef Fleischman AN, Azboy I, Fuery M, Restrepo C, Shao H, Parvizi J (2017) Effect of stem size and fixation method on mechanical failure after revision total knee arthroplasty. J Arthroplasty 32(9S):202–208CrossRef
12.
Zurück zum Zitat Gililland JM, Gaffney CJ, Odum SM, Fehring TK, Peters CL, Beaver WB (2014) Clinical and radiographic outcomes of cemented vs diaphyseal engaging cementless stems in aseptic revision TKA. J Arthroplasty 29(9 Suppl):224–228CrossRefPubMed Gililland JM, Gaffney CJ, Odum SM, Fehring TK, Peters CL, Beaver WB (2014) Clinical and radiographic outcomes of cemented vs diaphyseal engaging cementless stems in aseptic revision TKA. J Arthroplasty 29(9 Suppl):224–228CrossRefPubMed
13.
Zurück zum Zitat Gofton WT, Tsigaras H, Butler RA, Patterson JJ, Barrack RL, Rorabeck CH (2002) Revision total knee arthroplasty: fixation with modular stems. Clin Orthop Relat Res 404:158–168CrossRef Gofton WT, Tsigaras H, Butler RA, Patterson JJ, Barrack RL, Rorabeck CH (2002) Revision total knee arthroplasty: fixation with modular stems. Clin Orthop Relat Res 404:158–168CrossRef
14.
Zurück zum Zitat Gómez-Vallejo J, Albareda-Albareda J, Seral-García B, Blanco-Rubio N, Ezquerra-Herrando L (2018) Revision total knee arthroplasty: hybrid vs standard cemented fixation. J Orthop Traumatol 19:9CrossRefPubMedPubMedCentral Gómez-Vallejo J, Albareda-Albareda J, Seral-García B, Blanco-Rubio N, Ezquerra-Herrando L (2018) Revision total knee arthroplasty: hybrid vs standard cemented fixation. J Orthop Traumatol 19:9CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Greene JW, Reynolds SM, Stimac JD, Malkani AL, Massini MA (2013) Midterm results of hybrid cement technique in revision total knee arthroplasty. J Arthroplasty 28:570–574CrossRefPubMed Greene JW, Reynolds SM, Stimac JD, Malkani AL, Massini MA (2013) Midterm results of hybrid cement technique in revision total knee arthroplasty. J Arthroplasty 28:570–574CrossRefPubMed
16.
Zurück zum Zitat Haas SB, Insall JN, Montgomery W III, Windsor RE (1995) Revision total knee arthroplasty with use of modular components with stems inserted without cement. J Bone Jt Surg Am 77:1700–1707CrossRef Haas SB, Insall JN, Montgomery W III, Windsor RE (1995) Revision total knee arthroplasty with use of modular components with stems inserted without cement. J Bone Jt Surg Am 77:1700–1707CrossRef
17.
Zurück zum Zitat Insall JN, Dorr LD, Scott SRD, WN, (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14CrossRef Insall JN, Dorr LD, Scott SRD, WN, (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14CrossRef
18.
Zurück zum Zitat Kosse NM, van Hellemondt GG, Wymenga AB, Heesterbeek PJ (2017) Comparable stability of cemented vs press-fit placed stems in revision total knee arthroplasty with mild to moderate bone loss: 6.5-year results from a randomized controlled trial with radiostereometric analysis. J Arthroplasty 32:197–201CrossRefPubMed Kosse NM, van Hellemondt GG, Wymenga AB, Heesterbeek PJ (2017) Comparable stability of cemented vs press-fit placed stems in revision total knee arthroplasty with mild to moderate bone loss: 6.5-year results from a randomized controlled trial with radiostereometric analysis. J Arthroplasty 32:197–201CrossRefPubMed
19.
Zurück zum Zitat Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Jt Surg Am 89:780–785CrossRef Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Jt Surg Am 89:780–785CrossRef
20.
Zurück zum Zitat Lachiewicz PF, Soileau ES (2015) A 30-mm cemented stem extension provides adequate fixation of the tibial component in revision knee arthroplasty. Clin Orthop Relat Res 473:185–189CrossRefPubMed Lachiewicz PF, Soileau ES (2015) A 30-mm cemented stem extension provides adequate fixation of the tibial component in revision knee arthroplasty. Clin Orthop Relat Res 473:185–189CrossRefPubMed
21.
Zurück zum Zitat Larson DJ, Rosenberg JH, Lawlor MA, Garvin KL, Hartman CW, Lyden E, Konigsberg BS (2021) Pain associated with cemented and uncemented long-stemmed tibial components in revision total knee arthroplasty. Bone Jt J 103B(6 Suppl A):165–170CrossRef Larson DJ, Rosenberg JH, Lawlor MA, Garvin KL, Hartman CW, Lyden E, Konigsberg BS (2021) Pain associated with cemented and uncemented long-stemmed tibial components in revision total knee arthroplasty. Bone Jt J 103B(6 Suppl A):165–170CrossRef
22.
Zurück zum Zitat Lizaur-Utrilla A, Gonzalez-Parreño S, Martinez-Mendez D, Miralles-Muñoz FA, Lopez-Prats FA (2020) Minimal clinically important differences and substantial clinical benefits for knee society scores. Knee Surg Sports Traum Arthrosc 28:1473–1478CrossRef Lizaur-Utrilla A, Gonzalez-Parreño S, Martinez-Mendez D, Miralles-Muñoz FA, Lopez-Prats FA (2020) Minimal clinically important differences and substantial clinical benefits for knee society scores. Knee Surg Sports Traum Arthrosc 28:1473–1478CrossRef
23.
Zurück zum Zitat Lizaur-Utrilla A, Miralles-Muñoz FA, Ruiz-Lozano M, González-Parreño S, Alonso-Montero C, Lopez-Prats FA (2021) Better clinical outcomes and overall higher survival with hybrid versus cemented primary total knee arthroplasty: a minimum 15 years follow-up. Knee Surg Sports Traumatol Arthrosc 29:832–837CrossRefPubMed Lizaur-Utrilla A, Miralles-Muñoz FA, Ruiz-Lozano M, González-Parreño S, Alonso-Montero C, Lopez-Prats FA (2021) Better clinical outcomes and overall higher survival with hybrid versus cemented primary total knee arthroplasty: a minimum 15 years follow-up. Knee Surg Sports Traumatol Arthrosc 29:832–837CrossRefPubMed
24.
Zurück zum Zitat Manopoulos P, Havet E, Pearce O, Lardanchet JF, Mertl P (2012) Mid- to long-term results of revision total knee replacement using press-fit intramedullary stems with cemented femoral and tibial components. J Bone Jt Surg Br 94B:937–940CrossRef Manopoulos P, Havet E, Pearce O, Lardanchet JF, Mertl P (2012) Mid- to long-term results of revision total knee replacement using press-fit intramedullary stems with cemented femoral and tibial components. J Bone Jt Surg Br 94B:937–940CrossRef
25.
Zurück zum Zitat Mathis DT, Lohrer L, Amsler F, Hirschmann MT (2020) Reasons for failure in primary total knee arthroplasty: an analysis of prospectively collected registry data. J Orthop 23:60–66CrossRefPubMedPubMedCentral Mathis DT, Lohrer L, Amsler F, Hirschmann MT (2020) Reasons for failure in primary total knee arthroplasty: an analysis of prospectively collected registry data. J Orthop 23:60–66CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Patel JV, Masonis JL, Guerin J, Bourne RB, Rorabeck CH (2004) The fate of augments to treat type-2 bone defects in revision knee arthroplasty. J Bone Jt Surg Br 86B:195–199CrossRef Patel JV, Masonis JL, Guerin J, Bourne RB, Rorabeck CH (2004) The fate of augments to treat type-2 bone defects in revision knee arthroplasty. J Bone Jt Surg Br 86B:195–199CrossRef
27.
Zurück zum Zitat Peters CL, Erickson JA, Gililland JM (2009) Clinical and radiographic results of 184 consecutive revision total knee arthroplasties placed with modular cementless stems. J Arthroplasty 24(6 Suppl):48–53CrossRefPubMed Peters CL, Erickson JA, Gililland JM (2009) Clinical and radiographic results of 184 consecutive revision total knee arthroplasties placed with modular cementless stems. J Arthroplasty 24(6 Suppl):48–53CrossRefPubMed
28.
Zurück zum Zitat Shannon BD, Klassen JF, Rand JA, Berry DJ, Trousdale RT (2003) Revision total knee arthroplasty with cemented components and uncemented intramedullary stems. J Arthroplasty 18(7 Suppl 1):27–32CrossRefPubMed Shannon BD, Klassen JF, Rand JA, Berry DJ, Trousdale RT (2003) Revision total knee arthroplasty with cemented components and uncemented intramedullary stems. J Arthroplasty 18(7 Suppl 1):27–32CrossRefPubMed
29.
Zurück zum Zitat Sheridan GA, Garbuz DS, Masri BA (2021) Hybrid stems are superior to cemented stems in revision total knee arthroplasty: a systematic review and meta-analysis of recent comparative studies. Eur J Orthop Surg Traumatol 31:131–141CrossRefPubMed Sheridan GA, Garbuz DS, Masri BA (2021) Hybrid stems are superior to cemented stems in revision total knee arthroplasty: a systematic review and meta-analysis of recent comparative studies. Eur J Orthop Surg Traumatol 31:131–141CrossRefPubMed
30.
Zurück zum Zitat Skwara A, Figiel J, Knott T, Paletta JRJ, Fuchs-Winkelmann S, Tibesku CO (2009) Primary stability of tibial components in TKA: in vitro comparison of two cementing techniques. Knee Surg Sports Traumatol Arthrosc 17:1199–1205CrossRefPubMed Skwara A, Figiel J, Knott T, Paletta JRJ, Fuchs-Winkelmann S, Tibesku CO (2009) Primary stability of tibial components in TKA: in vitro comparison of two cementing techniques. Knee Surg Sports Traumatol Arthrosc 17:1199–1205CrossRefPubMed
31.
Zurück zum Zitat Stockwell KD, Malleck S, Gascoyne TC, Turgeon TR (2019) Clinical and radiographic outcomes of a hybrid fixation revision total knee arthroplasty system at short to mid-term follow-up. Knee 26:240–249CrossRefPubMed Stockwell KD, Malleck S, Gascoyne TC, Turgeon TR (2019) Clinical and radiographic outcomes of a hybrid fixation revision total knee arthroplasty system at short to mid-term follow-up. Knee 26:240–249CrossRefPubMed
32.
Zurück zum Zitat Wang C, Pfitzner T, von Roth P, Mayr HO, Sostheim M, Hube R (2016) Fixation of stem in revision of total knee arthroplasty: cemented versus cementless: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 24:3200–3211CrossRefPubMed Wang C, Pfitzner T, von Roth P, Mayr HO, Sostheim M, Hube R (2016) Fixation of stem in revision of total knee arthroplasty: cemented versus cementless: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 24:3200–3211CrossRefPubMed
33.
Zurück zum Zitat Whitehouse SL, Lingard EA, Katz JN, Learmonth ID (2003) Development and testing of a reduced WOMAC function scale. J Bone Jt Surg Br 85B:706–711CrossRef Whitehouse SL, Lingard EA, Katz JN, Learmonth ID (2003) Development and testing of a reduced WOMAC function scale. J Bone Jt Surg Br 85B:706–711CrossRef
34.
Zurück zum Zitat Wood GC, Naudie DD, MacDonald SJ, McCalden RW, Bourne RB (2009) Results of press-fit stems in revision knee arthroplasties. Clin Orthop Relat Res 467:810–817CrossRefPubMed Wood GC, Naudie DD, MacDonald SJ, McCalden RW, Bourne RB (2009) Results of press-fit stems in revision knee arthroplasties. Clin Orthop Relat Res 467:810–817CrossRefPubMed
Metadaten
Titel
Similar patient-reported outcomes for hybrid and cemented stem fixation for aseptic tibial revision total knee arthroplasty: a comparison of sequential prospective cohorts
verfasst von
Francisco A. Miralles-Muñoz
Matias Ruiz-Lozano
Adolfo Perez-Aznar
Emilio Sebastia-Forcada
Alejandro Lizaur-Utrilla
M. Flores Vizcaya-Moreno
Publikationsdatum
10.01.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 12/2022
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-022-06869-9

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