Cemented long-stem revision total knee arthroplasty.
Theoretical concerns about the use of cemented long-stemmed revision total knee arthroplasty include inducing stress shielding with adverse effects on prosthesis fixation. This study details the clinical outcome of 35 patients with 40 cemented long-stemmed kinematic stabilizer revision total knee arthroplasties at followup evaluation averaging 58.2 months (range, 24-111 months). Of these 40 revision arthroplasties, there were 25 long-stemmed tibial components and 38 long-stemmed femoral components. The Knee Society pain score improved from a preoperative value of 38 points (range, 4-80 points) to 83 points (range, 33-100 points) at last evaluation. The Knee Society function score improved from a preoperative value of 46 points (range, 5-100 points) to 64 points (range, 0-100 points) at last evaluation. Initial postoperative radiographs showed tibial bone-cement radiolucencies in 5 knees, but at final followup none of these radiolucencies had progressed. Radiolucencies developed in 5 additional tibial components by the time of final followup, but these were all incomplete and < 1 mm in width. Two femoral components had initial postoperative radiolucencies. These radiolucencies remained stable in 1 knee, whereas the other knee had asymptomatic radiographic loosening. Incomplete radiolucencies of < 1 mm developed in 3 additional femoral components at final followup. The incidence of tibial radiolucencies of 32% in the present study is similar to the incidence of radiolucencies with a nonstemmed revision cemented total knee arthroplasty, with the same prosthetic design, previously reported from the authors' institution.(ABSTRACT TRUNCATED AT 250 WORDS)
Murray
P B
PB
Department of Orthopedics, Mayo Clinic/Mayo Foundation, Rochester, MN 55905.
Rand
J A
JA
Hanssen
A D
AD
D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001843:Bone Cements; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D007720:Knee Prosthesis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D019736:Prostheses and Implants; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*
D001843:Bone Cements