title: Stemmed femoral implants show lower failure rates in revision total knee arthroplasty.
abstract: BACKGROUND
  Stemmed femoral implants are not universally used in revision total knee arthroplasty. The aim of this study was to evaluate whether the re-revision rate would be greater for revision total knees performed without stemmed femoral implants compared with revision total knees performed with stemmed femoral implants.
  
  
  METHODS
  All revision cases performed at a single institution between 2004 and 2011 were retrospectively reviewed. A total of 130 revision total knee arthroplasty procedures (63 Group 1; 67 Group 2) met the inclusion criteria.
  
  
  RESULTS
  Revisions performed without femoral stems failed more often than revisions with femoral stems (44% vs 9%, p<0.001) despite more severe pre-operative bone loss in groups that were revised with stems (p<0.05).
  
  
  CONCLUSIONS
  We recommend that femoral stems be used routinely in procedures where a femoral implant is revised following a prior total knee arthroplasty.
authors.affiliation: Department of Orthopaedic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States. Electronic address: Charles.Nelson@uphs.upenn.edu.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Nelson
authors.affiliation: Albany Medical College, Albany, NY, United States. Electronic address: mvanushkina@gmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: Vanushkina
authors.affiliation: Cankara Hospital, Ankara, Turkey. Electronic address: kaanirgit@yahoo.com.
authors.forename: Kaan
authors.initials: K
authors.lastname: Irgit
authors.affiliation: Department of Orthopaedics, Geisinger Medical Center, Danville, PA, United States. Electronic address: kastrohecker@geisinger.edu.
authors.forename: Kent
authors.initials: K
authors.lastname: Strohecker
authors.affiliation: Department of Orthopaedics, Geisinger Medical Center, Danville, PA, United States. Electronic address: trbowen@geisinger.edu.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Bowen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies
keywords: Bone loss; Revision total knee arthroplasty; Stems