Abstract
PurposeTo evaluate clinical and radiological outcome of the full cementation technique in revision total knee arthroplasty (TKA) using a constrained condylar knee (CCK) prosthesis.Materials and MethodsBetween January 2008 and March 2012, 18 cases (16 patients) of fully cemented revision TKA were performed using a CCK prosthesis. Fifteen cases of aseptic loosening (13 patients) and 3 cases of infection were included. There were 2 males and 14 females with a mean age of 76.7 years at the time of surgery, and the average follow-up was 81 months. Clinically, the pain score, function score and Hospital for Special Surgery (HSS) score were evaluated. Radiologically, loosening, radiolucent lines and migration of implant were evaluated.ResultsPreoperatively, the pain score, function score and HSS score were 50.3, 24.4 and 61.8 points, respectively. At the latest follow-up, the scores were improved to 84.8, 63.6 and 85.6 points, respectively (p<0.05). Loosening or migration of implant was not observed in any cases. Radiolucent lines were observed in 5 cases underneath the tibial component without progression during the follow-up.ConclusionsThe full cementation technique in revision TKA using a CCK showed excellent clinical results. Although radiolucent lines were observed in 27.8% underneath the tibial component, there was no progression to loosening or instability.
Highlights
The increasing number of total knee arthroplasties (TKAs) has led to a concomitant increase in revision surgeries[1,2,3])
There was no component migration, but radiolucent lines were observed in 5 cases underneath the tibial component
In 3 cases, the radiolucent line width increased during the follow-up, but it did not extend to the stem area and was confined underneath the tibial component
Summary
The increasing number of total knee arthroplasties (TKAs) has led to a concomitant increase in revision surgeries[1,2,3]). The restoration of lost bone support and joint stability is the main challenge in revision TKA4). The choice of implant type is based on accurate assessment of ligament quality, bone loss and component fixation; the least degree of constraint necessary is recommended[5]). In the case of revision surgery, the bone stock is often impaired. Vince and Long6) mentioned a press-fit mechanism in the hybrid fixation technique provided no sufficient fixation in cases with impaired bone quality. Well-designed press fit stems have been introduced and shown excellent results7); still there are some debates on the type of fixation, full cementation or hybrid cementation[8])
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