Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct 30;5(4):207-211.
doi: 10.1055/s-0037-1607427. eCollection 2017 Dec.

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

Giacomo Stefani  1 , Valerio Mattiuzzo  1 , Greta Prestini  1
Affiliations

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

Giacomo Stefani et al. Joints. .

Abstract

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.

Keywords: knee; methaphyseal sleeves; results; revision; total knee arthroplasty.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest One of the authors, G.S., is a paid consultant of DePuy Synthes.

Figures

Fig. 1
Fig. 1
AORI classification of bone defects in the femurs (blue) and tibias (red), at the time of revision surgery (number of cases on the y -axis; AORI types on the x -axis). AORI, Anderson Orthopaedic Research Institute.
Fig. 2
Fig. 2
Revision total knee arthroplasty for periprosthetic joint infection. ( A ) Osteotomy of anterior tibial tuberosity did not impair sleeve and implant stability. ( B , C ) Postoperative radiographs. Fixation of the tibial tuberosity can be achieved with metal wires, screws, or both.
Fig. 3
Fig. 3
( A , B ) Aseptic loosening of a total knee arthroplasty. Note the important bone loss both on distal femur and proximal tibia. A lytic area in the cortical bone of the lateral metaphyseal region of the tibia is evident. ( C , D ) Revision TKA of the same case at 33-month follow-up. Note the bone ingrowth in the lytic area.
See this image and copyright information in PMC

References

    1. Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster J Y. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004;86-A(05):963–974. - PubMed
    1. Rodriguez J A, Bhende H, Ranawat C S. Total condylar knee replacement: a 20-year followup study. Clin Orthop Relat Res. 2001;(388):10–17. - PubMed
    1. Schai P A, Thornhill T S, Scott R D. Total knee arthroplasty with the PFC system. Results at a minimum of ten years and survivorship analysis. J Bone Joint Surg Br. 1998;80(05):850–858. - PubMed
    1. Scuderi G R, Insall J N, Windsor R E, Moran M C. Survivorship of cemented knee replacements. J Bone Joint Surg Br. 1989;71(05):798–803. - PubMed
    1. Rand J A, Trousdale R T, Ilstrup D M, Harmsen W S. Factors affecting the durability of primary total knee prostheses. J Bone Joint Surg Am. 2003;85-A(02):259–265. - PubMed