title: Clinical and radiographic results of 184 consecutive revision total knee arthroplasties placed with modular cementless stems.
abstract: Clinical and radiographic outcomes of 184 consecutive revision total knee arthroplasties (TKAs) placed with cemented components and press-fit fluted cementless stems were reviewed at average follow-up of 49 months. Revision was performed for septic failure in 53 of 184 knees, periprosthetic fracture in 10 of 184 knees, and aseptic failure in 121 of 184 knees. The press-fit cementless stems were placed to tightly contact the endosteum of the metadiaphyseal area of the femur and tibia. No knees were re-revised for aseptic loosening. There were 15 failures (15/184, 8.2%): 13 were septic failures, 9 of which were recurrence of sepsis and 4 of which were new cases of sepsis. Average Knee Society knee score improved from 134.6 to 167.8 (P < .05). Revision TKA with modular cementless stems provided excellent fixation with no revisions for aseptic loosening. Re-revision for sepsis was the dominant failure mechanism with an overall rate of 7%. Given the increasing prevalence of revision TKA, sepsis prevention strategies should receive increased attention.
authors: Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.
authors: Christopher L
authors: CL
authors: Peters
authors: Jill A
authors: JA
authors: Erickson
authors: Jeremy M
authors: JM
authors: Gililland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D001843:Bone Cements; D005260:Female; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000502:physiology* / Q000601:surgery; D007720:Knee Prosthesis / Q000009:adverse effects* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements