Porous-Coated Metaphyseal Sleeves in Revision Total Knee Arthroplasty: Midterm Results

Abstract Purpose The aim of this study was to evaluate the efficacy in terms of clinical results and radiographic findings of using metaphyseal sleeves in revision total knee arthroplasty (TKA), and to check if the use of sleeves without stems did not impair such results. Methods In this retrospective study, 141 patients (143 knees) operated in the period 2008 to 2015 met the above-mentioned criteria and were invited to a medical examination including X-rays. A total of 121 knees were available for the study (44 in the group without stems and 77 in the group with stems). Mean follow-up was 63 months for the stemless group and 89 for the group with stems. Knee Society Score (KSS) (objective knee score) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used as outcome scores and compared with baseline values, range of motion (ROM) was also compared with preop value and X-rays were also examined and compared with immediate postop X-rays to check signs of loosening and radiolucent lines, if any, and bone ingrowth. Satisfaction of the patients was also investigated using a linear scale from 1 to 10. Results KSS improved from 34 to 81 postop (39 to 81 in the stemless group) (p < 0.01), while WOMAC from 82% preop to 39% postop (76 to 37% in the stemless group) (p < 0.01). Forty-six patients were satisfied, 20 partially satisfied, and 11 unsatisfied (respectively 25–14–5 in the stemless group). ROM improved from 89 degrees preop to 99 degrees postop (93 to 98 degrees in the stemless group). X-rays showed no loosening of the implant, radiolucent lines in 8 patients, and bone ingrowth in 113 out of 121 patients. Conclusion In this midterm follow-up study, we found a significant improvement in clinical results compared with preop values. We found no difference between the two groups (with and without stems) thus suggesting that the use of stemless sleeves does not impair results in revision TKA. Level of Evidence Therapeutic case series, level IV.

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Radiolucent lines are decreased at 3 years following total knee arthroplasty using trabecular metal tibial components

Journal of International Medical Research ◽

10.1177/0300060518757927 ◽

2018 ◽

Vol 46 (5) ◽

pp. 1919-1927 ◽

Cited By ~ 5

Author(s):

Hirotaka Mutsuzaki ◽

Arata Watanabe ◽

Tomonori Kinugasa ◽

Kotaro Ikeda

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

X Rays ◽

Trabecular Metal ◽

Change Over Time ◽

Radiolucent Lines ◽

Total Knee ◽

Over Time

Objective To analyse location and frequency, and change over time, of radiolucent lines (RLLs) around trabecular metal tibial components in total knee arthroplasty (TKA). Methods Osteoarthritic knees in patients who had undergone TKA were retrospectively evaluated via analysis of RLLs on anteroposterior and lateral X-rays obtained at 2 and 6 months, and 1, 2 and 3 years following TKA. Results In 125 osteoarthritic knees from 90 patients (mean age, 75.0 ± 6.2; 21 male/69 female), frequency of RLLs around trabecular metal tibial components was generally highest at 2 and 6 months, and 1 year following TKA, then gradually decreased over the 3-year follow-up. Frequency of RLLs around trabecular metal tibial components was greater at the tip of the two pegs, particularly the medial peg, and around the pegs, versus other zones. No postoperative revisions were performed for loosening. Conclusions Over 3 years following TKA, RLLs were most frequently observed up to 1 year, then gradually decreased. RLLs were significantly more frequent in the medial peg zone and zones close to the medial peg than in other zones.

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Revision Total Knee Arthroplasty with Metaphyseal Sleeves without Stem: Short-Term Results

Joints ◽

10.1055/s-0037-1607427 ◽

2017 ◽

Vol 05 (04) ◽

pp. 207-211 ◽

Cited By ~ 13

Author(s):

Giacomo Stefani ◽

Valerio Mattiuzzo ◽

Greta Prestini

Keyword(s):

Total Knee Arthroplasty ◽

Retrospective Study ◽

Knee Arthroplasty ◽

Bone Ingrowth ◽

Womac Score ◽

Revision Total Knee Arthroplasty ◽

X Rays ◽

Short Term ◽

Total Knee ◽

Baseline Values

Purpose The aim of this study was to evaluate the efficacy of revision total knee arthroplasty (TKA) with cementless metaphyseal sleeves without stems either in the femoral or tibial side or in both. Methods In this retrospective study, 51 patients (51 knees) operated in the period 2010 to 2015 met the above-mentioned criteria and were invited to a medical examination including X-rays. Forty-six were available for the study. Mean follow-up was 37 months. Knee Society score (KSS) (objective knee score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and range of motion (ROM) were used as outcome scores and compared with baseline values. X-rays were also examined and compared with postoperative exams to evaluate the presence of loosening, radiolucent lines, and bone ingrowth. Satisfaction of the patients was also investigated using a linear scale from 1 to 10. Results KSS improved from 39 to 77 (p < 0.01); WOMAC score improved from 76 to 41 (p < 0.01). Twenty-four (52%) patients were satisfied, 15 (32%) were partially satisfied, and 7 (16%) were unsatisfied. ROM improved from 93 to 96 degrees (nonsignificant difference). X-rays showed no loosening of the implants, radiolucent lines in 4 patients (3 of them were asymptomatic) and bone ingrowth in 43 out of 46 patients. Conclusion In this short-term retrospective study, the use of sleeves without stem was a safe and effective procedure in revision TKA. We found a significant improvement in clinical results compared with baseline values and no signs of implant loosening. Level of Evidence Level IV, therapeutic case series.

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Clinical Results of Total Knee Arthroplasty by Using Improved Cement Technique by Interposing Hydroxyapatite Granules

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.330-332.819 ◽

2007 ◽

Vol 330-332 ◽

pp. 819-822

Author(s):

Sok Chol Kim ◽

Hironobu Oonishi ◽

Hiroyuki Oonishi Jr. ◽

Hirotsugu Ohashi

Keyword(s):

Total Knee Arthroplasty ◽

Bone Cement ◽

Knee Arthroplasty ◽

Bone Ingrowth ◽

Clinical Results ◽

Periprosthetic Osteolysis ◽

Radiolucent Lines ◽

Ha Coating ◽

Appearance Rate ◽

Total Knee

Improved cement technique by interposing less than two layers of hydroxyapatite (HA) granules between bone and bone cement at the cementing (Interface Bioactive Bone Cement : IBBC) have been performed in total knee arthroplasty (TKA). 140 knees (120 patients) could be followed up clinically and radiologically. As a control, clinical results of TKA with conventional cementing (Non-IBBC) were used. In IBBC cases, the appearance rate of the radiolucent lines on the tibial components and the periprosthetic osteolysis of the tibial components were significantly low. In IBBC, bone cement bound to HA mechanically immediately after surgery and HA granules bound to the bone physicochemically after bone ingrowth into the spaces around the HA granules. Thus, we believe that IBBC is a method combining the advantage of cementless HA coating and bone cement.

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Outcomes of the rotating hinge knee in revision total knee arthroplasty with a median follow-up of 6.2 years

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04205-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jake von Hintze ◽

Mika Niemeläinen ◽

Harri Sintonen ◽

Jyrki Nieminen ◽

Antti Eskelinen

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Survival Rate ◽

Knee Arthroplasty ◽

Revision Total Knee Arthroplasty ◽

Patient Reported ◽

Total Knee ◽

Revision Tka

Abstract Background The purpose of this study was to determine the mid-term clinical, radiographic and health-related quality of life (HRQoL) outcomes and define the survival rate in patients who had undergone revision total knee arthroplasty (TKA) using the single rotating hinged knee (RHK) design. Methods Between January 2004 and December 2013, 125 revision TKAs were performed at our institution using the single RHK implant. We conducted both a retrospective analysis of prospectively collected outcome data of these patients and a prospective follow-up study of all 39 living patients (41 knees). The follow-up phase included an optional extra follow-up visit, PROM questionnaires, and plain radiographs. Results The ten-year Kaplan-Meier survival rate of the revision RHK knees was 81.7% (95% CI 71.9–91.6%) with re-revision for any reason as the endpoint. Overall, 15 knees (12% of the total) underwent re-revision surgery during the follow-up. The median follow-up was 6.2 years (range, 0–12.7 years) post-operatively for the baseline group. One mechanical hinge mechanism-related failure occurred without any history of trauma or infection. At the time of the final follow-up, the majority of patients evinced a fairly good clinical outcome measured with patient-reported outcome measures and none of the components were radiographically loose. Conclusion We found that in patients undergoing complex revision TKA, fairly good functional outcome and quality of life can be achieved using an RHK implant. Further, it seems that in this type of patient cohort, revision TKA using an RHK implant relieves pain more than it improves ability to function. The NexGen® RHK design can be regarded as a suitable option in complex revision TKA.

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