title: The use of metaphyseal sleeves in revision total knee arthroplasty.
abstract: BACKGROUND
  Bone loss in revision total knee arthroplasty is common. Various reconstruction options are available. The purpose of our study is to report on one such reconstruction option, titanium metaphyseal sleeves.
  
  
  METHODS
  We describe a series of 45 patients (46 knees) who underwent revision total knee arthroplasty and were treated with a porous metaphyseal sleeve between August 2000 and September 2009 at two centers. Patients were followed for a minimum of four years, and at final follow-up, 40 patients (40 knees) were available for review. Patients were evaluated using The Knee Society's Knee Scoring System at each follow-up. Radiographs (standing anteroposterior, lateral, and sunrise views) were taken at six weeks, three months, and final evaluations.
  
  
  RESULTS
  Mean Knee Society Scores increased from 36 (range 10 to 69) pre-operatively to 90 (range 38 to 100) at final follow-up. Mean alignment on final radiographic evaluation was 5° (range 3° to 8° valgus). Mean pre-operative alignment was 6° (range 15° varus to 18° valgus). Mean range of motion was 125° (range 80° to 140°) pre-operatively and 115° (range 95° to 130°) postoperatively. One device failed to achieve ingrowth and was revised at two years. All other knees were radiographically stable and ingrown.
  
  
  CONCLUSIONS
  Metaphyseal sleeves provide an alternative for bone loss reconstruction in revision total knee arthroplasty.
  
  
  METHODS
  III.
authors.affiliation: The St. Joseph Medical Center, 7601 Osler Dr, Towson, MD 21204, United States. Electronic address: ddalury@gmail.com.
authors.forename: David F
authors.initials: DF
authors.lastname: Dalury
authors.affiliation: Proliance Orthopedic Associates, 4011 Talbot Rd. S., Renton, WA 98055, United States.
authors.forename: William P
authors.initials: WP
authors.lastname: Barrett
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation*; D001862:Bone Resorption / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D013977:Tibia / Q000601:surgery*
keywords: Metaphyseal sleeves; Revision total knee arthroplasty