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. 2020 Sep 9;15(1):393.
doi: 10.1186/s13018-020-01921-1.

Modified hybrid cementing technique reduces stem tip pain and improves patient's satisfaction after revision total knee arthroplasty

Man Soo Kim  1 , In Jun Koh  2 , Sueen Sohn  2 , Hyung Chul Park  1 , Yong In  3   4
Affiliations

Modified hybrid cementing technique reduces stem tip pain and improves patient's satisfaction after revision total knee arthroplasty

Man Soo Kim et al. J Orthop Surg Res. .

Abstract

Background: There have been no studies comparing patient-reported outcome measures including end-of-stem tip pain and patient satisfaction based on the use of cementing techniques in revision total knee arthroplasty (TKA). The purpose of this study was to compare end-of-stem tip pain and PROMs with hybrid and modified hybrid cementing techniques in revision TKAs.

Method: Sixty-two cases of revision TKA performed by a single surgeon were divided into two groups based on the cementing technique with a minimum follow-up of 2 years. Two types of cementing technique for femoral and tibial stems were used as follows: (1) a hybrid cementing technique (33 cases), in which cement was applied immediately distal to the modular junction of the stem and the component while the distal stem was press-fitted into the diaphysis without using cement; and (2) a modified hybrid cementing technique (29 cases), in which cement was applied to the tip of femoral and tibial stems. The thigh and shin were assessed for the end-of-stem tip pain. Patient satisfaction was evaluated based on the satisfaction items of New Knee Society Score.

Results: Modified hybrid cementing significantly lowered the percentage of patients manifesting shin pain (3.4% vs. 24.2%, p = 0.029). Patients treated with the modified hybrid cementing technique showed a higher satisfaction rate (p = 0.003). Multivariate logistic regression analysis showed an increase in the odds of satisfaction 32.686-fold (p = 0.004) in patients without pain at the end-of-stem tip in the shin and 9.261-fold (p = 0.027) in patients treated with the modified hybrid cementing technique.

Conclusion: The modified hybrid cementing technique for fixation of long-stem in revision TKAs reduced the end-of-stem tip pain in the shin, leading to significantly higher satisfaction compared with the hybrid cementing technique after revision TKA.

Level of evidence: Level III.

Keywords: Cementing technique; Revision total knee arthroplasty; Satisfaction; Stem tip pain.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Two types of cementing technique for femoral and tibial stem fixation. With the hybrid technique, the cement was applied around the implant immediately distal to the modular junction of the stem and the component while the distal stem was press-fitted into the diaphysis without cement (a, b). With the modified hybrid cementing technique, in addition to the hybrid technique, the cement was also used at the tip of femoral and tibial stems (c, d)
See this image and copyright information in PMC

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