title: Aseptic failure: how does the Compress(®) implant compare to cemented stems?
abstract: BACKGROUND
  Failure of endoprosthetic reconstruction with conventional stems due to aseptic loosening remains a challenge for maintenance of limb integrity and function. The Compress(®) implant (Biomet Inc, Warsaw, IN, USA) attempts to avoid aseptic failure by means of a unique technologic innovation. Though the existing literature suggests survivorship of Compress(®) and stemmed implants is similar in the short term, studies are limited by population size and followup duration.
  
  
  OBJECTIVE
  We therefore compared (1) the rate of aseptic failure between Compress(®) and cemented intramedullary stems and (2) evaluated the overall intermediate-term implant survivorship.
  
  
  METHODS
  We reviewed 26 patients with Compress(®) implants and 26 matched patients with cemented intramedullary stems. The patients were operated on over a 3-year period. Analysis focused on factors related to implant survival, including age, sex, diagnosis, infection, aseptic loosening, local recurrence, and fracture. Minimum followup was 0.32 years (average, 6.2 years; range, 0.32-9.2 years).
  
  
  RESULTS
  Aseptic failure occurred in one (3.8%) patient with a Compress(®) implant and three (11.5%) patients with cemented intramedullary stems. The 5-year implant survival rate was 83.5% in the Compress(®) group and 66.6% in the cemented intramedullary stem group.
  
  
  CONCLUSIONS
  The Compress(®) implant continues to be a reliable option for distal femoral limb salvage surgery. Data regarding aseptic failure is encouraging, with equivalent survivorship against cemented endoprosthetic replacement at intermediate-term followup.
  
  
  METHODS
  Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors: Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA 94115-1939, USA.
authors: Andrew C
authors: AC
authors: Pedtke
authors: Rosanna L
authors: RL
authors: Wustrack
authors: Andrew S
authors: AS
authors: Fang
authors: Robert J
authors: RJ
authors: Grimer
authors: Richard J
authors: RJ
authors: O'Donnell
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D002484:Cementation; D002648:Child; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D012516:Osteosarcoma / Q000601:surgery*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult