Total knee replacement with interlocking stems: a preliminary report.
Revision total knee replacements or primary total knee replacements with large amounts of bone loss frequently require long-stemmed prostheses to stabilize the components. The hypothesis of the current study was that long-stemmed prostheses can be fixed with interlocking screws, provide a successful outcome, avoid extensive stress-shielding, and allow easy revision in the future. Ten patients with a minimum 2-year followup were studied. Outcomes were studied preoperatively and postoperatively using the Short Form-12 questionnaires, physical examinations, and radiographs. Complications were recorded. Ability to do activities of daily living, strenuous work, and sedentary work were recorded on a 10-point analog scale. Results indicated that 80% of stems well-fixed as shown on serial radiographs, functional outcome scores postoperatively improved significantly from preoperatively, pain was improved significantly, and positive bone remodeling without stress-shielding was seen in 80% of patients, but 20% had significant stress-shielding in the metaphysis. Complications included two periprosthetic fractures for which the patients did not require revision surgery, and one infection. Long-stemmed total knee components with interlocking fixation seem to be a reasonable alternative when large bone defects exist in the femur or tibia.
Rodrigo
J J
JJ
University of California, Davis Medical Center, Sacramento 95817, USA.
Hazelwood
S J
SJ
Farver
T B
TB
Nyman
J S
JS
D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001863:Bone Screws; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D016896:Treatment Outcome