Metaphyseal sleeves in revision total knee arthroplasty: Minimum seven-year follow-up study

Abstract

Background: Metal metaphyseal sleeves are an option for reconstruction as well as enhancing fixation in managing challenging bone defects in revision knee replacement. We report our results of revision knee replacement using metaphyseal sleeves with a minimum of seven years of follow-up.

Methods: The records of 103 patients (104 knees) who underwent revision knee replacement using metaphyseal sleeves in our centre were evaluated. The follow-up included clinical assessment, functional scores and radiologic assessment.

Results: The mean age of patients was 74.7 (tange 58-92) years. Mean follow-up was 95.7 (range, 88-115) months. From the original cohort, 15 (14%) patients had died from unrelated causes. During the follow-up period, there were 23 (22.1%) re-revisions. Indications for re-revision was aseptic loosening in seven (6.7%), stiffness in four (3.8%), infection in five (4.8%), instability in three (2.8%) and persistent pain in two (1.9%) patients. For aseptic loosening, the average time for re-revisions was 56.6 months (range 25 to 84). Radiographically, all unrevised sleeves were well-fixed, without any evidence of loosening. Oxford knee score in patients without re-revisions was 28.5 (range four to 48).

Conclusion: At mid-term follow-up, metaphyseal sleeves demonstrate durable clinical results and radiographic fixation.

Keywords: Arthroplasty; Knee; Metaphyseal sleeve; Midterm; Replacement; Revision; Sleeve.