Revision total knee arthroplasty: fixation with modular stems.
The number of revision total knee replacements continues to increase annually. To date, much of the literature has focused on the performance of titanium revision systems. The primary aim of the current study was to review the mid term results of a contemporary revision knee system, with alternative design features. Ninety-one consecutive patients having aseptic revision total knee arthroplasty with one, modular all-cobalt chrome stemmed revision knee system using hybrid stem fixation were studied prospectively. Eighty-nine revisions in 84 patients were reviewed at a mean of 5.9 years (range, 4.1-8.6 years). Significant improvements in pain scores (15 +/- 14 to 38 +/- 14), function (40 +/- 24 to 53 +/- 29), range of motion (88 degrees +/- 23 degrees to 98 degrees +/- 18 degrees ), and total Knee Society score (85 +/- 40 to 132 +/- 40) were seen at followup. Five patients had revision surgery, with a Kaplan-Meier survivorship of 93.5% at 8.6 years. Intermediate results support the use of cobalt chrome components and hybrid cement fixation; however, this fixation in combination with high articular constraint requires continued monitoring.
Gofton
Wade T
WT
University of Western Ontario, London, Ontario, Canada.
Tsigaras
Harry
H
Butler
R Allen
RA
Patterson
James J
JJ
Barrack
Robert L
RL
Rorabeck
Cecil H
CH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D002858:Chromium Alloys; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation
D002858:Chromium Alloys