Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Reviews in Musculoskeletal Medicine
Erschienen in: Current Reviews in Musculoskeletal Medicine 4/2015

01.12.2015 | Revision Knee Arthroplasty (R Rossi, Section Editor)

Stem length in revision total knee arthroplasty

verfasst von: Anay Rajendra Patel, Brian Barlow, Amar S. Ranawat

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 4/2015

Einloggen, um Zugang zu erhalten

Abstract

Stems are intramedullary extensions of either the femoral or tibial component of a total knee arthroplasty (TKA) designed to increase the mechanical stability to decrease the risk of aseptic loosening. Biomechanical studies have shown that TKA stems increase the mechanical stability by transferring load over a larger area and thereby reduce strain at the bone-component interface [1‐4]. The length of a revision TKA stem is determined by the patient’s anatomy and the intended fixation, namely fully cemented or press-fit cortical contact. The advantages and disadvantages of various stem lengths must be weighed against the needs of the patient to achieve an optimal outcome.
Literatur
1.
Bertin KC. Tibial component fixation in total knee arthroplasty: a comparison of pegged and stemmed designs. J Arthroplast. 2007;22(5):670.CrossRef
2.
Rawlinson JJ, Peters LE, Campbell DA, Windsor R, Wright TM, Bartel DL. Cancellous bone strains indicate efficacy of stem augmentation in constrained condylar knees. Clin Orthop Relat Res. 2005;440:107.CrossRefPubMed
3.
Conlisk N, Gray H, Pankaj P, Howie C. The influence of stem length and fixation on initial femoral component stability in revision total knee replacement. Bone Joint Res. 2012;1(11):281.PubMedCentralCrossRefPubMed
4.
Pérez-Blanca A, Prado M, Ezquerro F, Montañéz E, Espejo A. Addition of a short central extension to surface cemented tibial trays in primary TKA: an in vitro study of the effect on initial fixation stability and its relationship to supporting bone density. Clin Biomecha. 2008;23(4):483.CrossRef
5.
Riley Jr LH. The evolution of total knee arthroplasty. Clin Orthop Relat Res. 1976;120:7.PubMed
6.
7.
Phillips H, Taylor J. The Walldius hinge arthroplasty. J Bone Joint Surg Br. 1975;57(59).
8.
Robinson RP. The early innovators of today’s resurfacing condylar knees. J Arthroplast. 2005;20:2.CrossRef
9.
Eftekhar N. Total knee-replacement arthroplasty. Results with the intramedullary adjustable total knee prosthesis. J Bone Joint Surg. 1983;65(3):293.PubMed
10.
Haas SB, Insall JN, Montgomery W, Windsor RE. Revision total knee arthroplasty with use of modular components with stems inserted without cement. The Journal of Bone & Joint Surgery 77(11): 1700, 1995 .
11.
Jazrawi LM, Bai B, Kummer FJ, Hiebert R, Stuchin SA. The effect of stem modularity and mode of fixation on tibial component stability in revision total knee arthroplasty. J Arthroplast. 2001;16(6):759.CrossRef
12.
Mabry TM, Hanssen AD. The role of stems and augments for bone loss in revision knee arthroplasty. J Arthroplast. 2007;22(4):56.CrossRef
13.
Mabry TM, Vessely MB, Schleck CD, Harmsen WS, Berry DJ. Revision total knee arthroplasty with modular cemented stems: long-term follow-up. J Arthroplast. 2007;22(6):100.CrossRef
14.
Haidukewych GJ, Hanssen A. Metaphyseal fixation in revision total knee arthroplasty: indications and techniques. J Am Acad Orthop Surg. 2011;19(6):311.PubMed
15.
Fehring TK, Odum S, Olekson C, Griffin WL, Mason JB, McCoy TH. Stem fixation in revision total knee arthroplasty: a comparative analysis. Clin Orthop Relat Res. 2003;416:217.CrossRefPubMed
16.
Kim Y-H, Kim J-S. Revision total knee arthroplasty with use of a constrained condylar knee prosthesis. J Bone Joint Surg. 2009;91(6):1440.CrossRefPubMed
17.
Murray PB, Rand JA, Hanssen AD. Cemented long-stem revision total knee arthroplasty. Clin Orthop Relat Res. 1994;309:116.PubMed
18.
Whaley AL, Trousdale RT, Rand JA, Hanssen AD. Cemented long-stem revision total knee arthroplasty. J Arthroplast. 2003;18(5):592.CrossRef
19.
Barrack R, Stanley T, Burt M, Hopkins S. The effect of stem design on end of stem pain in revision TKA. J Arthroplast. 2004;19(2):256.CrossRef
20.
Barrack RL, Engh G, Rorabeck C, Sawhney J, Woolfrey M. Patient satisfaction and outcome after septic versus aseptic revision total knee arthroplasty. J Arthroplast. 2000;15(8):990.CrossRef
21.
Barrack RL, Rorabeck C, Burt M, Sawhney J. Pain at the end of the stem after revision total knee arthroplasty. Clin Orthop Relat Res. 1999;367:216.PubMed
22.
Shannon BD, Klassen JF, Rand JA, Berry DJ, Trousdale RT. Revision total knee arthroplasty with cemented components and uncemented intramedullary stems. J Arthroplast. 2003;18:27.CrossRef
23.
Whiteside L. Cementless fixation issues in revision total knee arthroplasty. Instr Course Lect. 1998;48:177.
24.
Elia EA, Lotke PA. Results of revision total knee arthroplasty associated with significant bone loss. Clin Orthop Relat Res. 1991;271:114.PubMed
25.
Bistolfi A, Massazza G, Rosso F, Crova M. Rotating-hinge total knee for revision total knee arthroplasty. Orthopedics. 2012;35(3):185.
26.•
Gililland JM, Gaffney CJ, Odum SM, Fehring TK, Peters CL, Beaver WB. Clinical & radiographic outcomes of cemented vs. diaphyseal engaging cementless stems in aseptic revision TKA. J Arthroplasty. 2014;29(9):224. Recent literature on the outcomes of short cemented stems compared to longer uncemented stems in aseptic revision TKR.CrossRefPubMed
27.
Parsley BS, Sugano N, Bertolusso R, Conditt MA. Mechanical alignment of tibial stems in revision total knee arthroplasty. J Arthroplast. 2003;18:33.CrossRef
28.
Nakasone CK, Abdeen A, Khachatourians AG, Sugimori T, Vince KG. Component alignment in revision total knee arthroplasty using diaphyseal engaging modular offset press-fit stems. J Arthroplast. 2008;23(8):1178.CrossRef
29.
Skwara A, Figiel J, Knott T, Paletta J, Fuchs-Winkelmann S, Tibesku C. Primary stability of tibial components in TKA: in vitro comparison of two cementing techniques. Knee Surgery, Sports Traumatology, Arthroscopy 17(10): 1199, 2009
30.
Sathappan SS, Pang H-N, Manoj A, Ashwin T, Satku K. Does stress shielding occur with the use of long-stem prosthesis in total knee arthroplasty? Knee Surgery, Sports Traumatology, Arthroscopy. 2009;17(2):179.CrossRefPubMed
31.
Kawano T, Miura H, Nagamine R, Urabe K, Matsuda S, Mawatari T, et al. Alignment in total knee arthroplasty following failed high tibial osteotomy. J knee Surg. 2003;16(3):168.PubMed
32.
Nagamine R, Miura H, Bravo CV, Urabe K, Matsuda S, Miyanishi K, et al. Anatomic variations should be considered in total knee arthroplasty. J Orthop Sci. 2000;5(3):232.CrossRefPubMed
33.
Gobba MS, Chan N, Patel R, Noble PC, Incavo SJ. Tibial stems in revision total knee arthroplasty: is there an anatomic conflict? The Journal of arthroplasty, 2015
34.
Scuderi GR. Revision total knee arthroplasty: how much constraint is enough? Clin Orthop Relat Res. 2001;392:300.CrossRefPubMed
35.
Sah AP, Shukla S, Della Valle CJ, Rosenberg AG, Paprosky WG. Modified hybrid stem fixation in revision TKA is durable at 2 to 10 years. Clinical Orthopaedics and Related Research. 2011;469(3):839.PubMedCentralCrossRefPubMed
36.
Lehmann W, Rupprecht M, Nuechtern J, Melzner D, Sellenschloh K, Kolb J, et al. What is the risk of stress risers for interprosthetic fractures of the femur? A biomechanical analysis. Int Orthopaedics. 2012;36(12):2441.CrossRef
37.
Cipriano CA, Brown NM, Della Valle CJ, Moric M, Sporer SM. Intra-operative periprosthetic fractures associated with press fit stems in revision total knee arthroplasty: incidence, management, and outcomes. J Arthroplast. 2013;28(8):1310.CrossRef
38.•
Lachiewicz PF, Soileau ESA. 30-mm cemented stem extension provides adequate fixation of the tibial component in revision knee arthroplasty. Clin Orthopaedics Relat Res. 2015;473(1):185. Recent literature on the outcomes of short cemented stems in revision arthroplasty. Places specific focus on the role of metaphyseal fixation.CrossRef
39.
Meneghini RM, Lewallen DG, Hanssen AD. Use of porous tantalum metaphyseal cones for severe tibial bone loss during revision total knee replacement. J Bone Joint Surg Am Volume. 2008;90(1):78.CrossRef
40.•
Edwards PK, Fehring TK, Hamilton WG, Perricelli B, Beaver WB, Odum SM. Are cementless stems more durable than cemented stems in two-stage revisions of infected total knee arthroplasties? Clin Orthopaedics Related Res. 2014;472(1):206. Recent literation on the outcomes of short cemented vs. longer uncemented stems in revision TKR for septic two-stage revisions. Highlights the higher prevalence of radiographic lucencies seen with shorter cemented stems compared to uncemented stems.CrossRef
41.
Van Loon C, de Waal MM, Buma P, Verdonschot N, Veth R. Femoral bone loss in total knee arthroplasty. Rev Acta Orthopaedica Belgica. 1999;65(2):154.
42.
Bédard M, Cabrejo-Jones K, Angers M, Pelletier-Roy R, Pelet S. The effect of porous tantalum cones on mechanical alignment and canal-fill ratio in revision total knee arthroplasty performed with uncemented stems. The Journal of arthroplasty, 2015
Metadaten
Titel
Stem length in revision total knee arthroplasty
verfasst von
Anay Rajendra Patel
Brian Barlow
Amar S. Ranawat
Publikationsdatum
01.12.2015
Verlag
Springer US
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 4/2015
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-015-9297-4

Weitere Artikel der Ausgabe 4/2015

Current Reviews in Musculoskeletal Medicine 4/2015 Zur Ausgabe

Cartilage Repair Techniques in the Knee (A Dhawan, Section Editor)

Cell-based chondral restoration

Orthopedic Oncology: New Concepts and Techniques (JH Schwab, Section Editor)

Techniques in surgical navigation of extremity tumors: state of the art

Cartilage Repair Techniques in the Knee (A Dhawan, Section Editor)

Particulated articular cartilage for symptomatic chondral defects of the knee

Cartilage Repair Techniques in the Knee (A Dhawan, Section Editor)

Osteochondral allograft

Cartilage Repair Techniques in the Knee (A Dhawan, Section Editor)

Knee cartilage defect: marrow stimulating techniques

Revision Knee Arthroplasty (R. Rossi, Section Editor)

Painful knee arthroplasty: current practice

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise