title: Results of press-fit stems in revision knee arthroplasties.
abstract: The ideal method of stem fixation in revision knee arthroplasty is controversial with advantages and disadvantages for cemented and press-fit designs. Studies have suggested cemented revision knee stems may provide better long-term survival. The aim of this study was to report our experience with press-fit uncemented stems and metaphyseal cement fixation in a selected series of patients undergoing revision total knee arthroplasty. One hundred twenty-seven patients (135 knees) who underwent revision total knee arthroplasty using a press-fit technique (press-fit diaphyseal fixation and cemented metaphyseal fixation) were reviewed. Minimum followup was 2 years (mean, 5 years; range, 2-12 years). A Kaplan-Meier survivorship analysis using an end point of revision surgery or radiographic loosening was used to determine probability of survival at 5 and 10 years. Of the 127 patients (135 knees), 31 patients (36 knees) died and two patients (two knees) were lost to followup. Six patients (six knees) had revisions at a mean of 3.5 years (range, 1-8 years). Kaplan-Meier survivorship analysis revealed a probability of survival free of revision for aseptic loosening of 98% at 12 years. Survivorship of press-fit stems for revision knee arthroplasty is comparable to reported survivorship of cemented stem revision knee arthroplasty. Radiographic analysis has shown continued satisfactory appearances regardless of constraint, stem size, and augmentations.
authors.affiliation: Department of Surgery (Orthopaedics), Kingston General Hospital, Queens University, Victory 3, Room 315, Stuart Street, Kingston, ON, Canada K7L 2V7.
authors.forename: Gavin C
authors.initials: GC
authors.lastname: Wood
authors.forename: Douglas D R
authors.initials: DD
authors.lastname: Naudie
authors.forename: Steven J
authors.initials: SJ
authors.lastname: MacDonald
authors.forename: Richard W
authors.initials: RW
authors.lastname: McCalden
authors.forename: Robert B
authors.initials: RB
authors.lastname: Bourne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation*; D001843:Bone Cements / Q000627:therapeutic use*; D018483:Diaphyses / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D014025:Titanium