Abstract

BackgroundPorous-coated metaphyseal sleeves are designed to fill bone loss and facilitate osseo-integration when bone loss occurs during revision total knee arthroplasty (TKA). The purpose of this paper was to evaluate the clinical and radiographic outcomes of porous-coated metaphyseal sleeves for severe bone loss in revision TKA.MethodsForm December 2014 to March 2018, we retrospectively analyzed 36 patients receiving revision TKAs. They had Anderson Orthopaedic Research Institute (AORI) Type II and III tibial bone loss and were treated with metaphyseal sleeve. The patients were followed up for a mean time of 28.5 months. The Knee Society Score (KSS), the Hospital for Special Surgery (HSS) Knee Score, Visual Analog Scale (VAS) score and the range of motion (ROM), radiographic findings of sleeve osteo-integration were also recorded. The paired t test was used to compare the KSS, the HSS knee score and VAS score before and after the revision TKAs. A value of P < 0.05 was considered statistically significant.ResultsThirty-six patients had complete clinical and radiographic data. At the final follow-up (mean: 28.5 months), significant improvements in knee range of motion, KSS, HSS score and VAS score were observed postoperatively (P < 0.001 for all). No aseptic implant fixation failure occurred. Radiographic reviews at the final follow-up revealed that components were stable without occurrence of component migration or clinically significant osteolysis.ConclusionsThis short-term retrospective study illustrated that porous-coated metaphyseal sleeves were useful in revision TKA, with a low rate of intraoperative complications, excellent osteo-integration and stable fixation.

Highlights

  • The clinical efficacy of knee arthroplasty for the treatment of end-stage knee osteoarthritis has been recognized [1]

  • The purpose of this study was, to evaluate the clinical and radiographic outcomes of porous-coated metaphyseal sleeves used for severe bone loss in Chinese people during revision total knee arthroplasty (TKA)

  • From December 2014 to March 2018, a retrospective study was conducted in 36 consecutive patients with Anderson Orthopaedic Research Institute (AORI) II or AORI III bone loss who underwent a revision TKA using a press-fit tibial and/or femoral porous-coated metaphyseal sleeve

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Summary

Introduction

The clinical efficacy of knee arthroplasty for the treatment of end-stage knee osteoarthritis has been recognized [1]. With virtually all knee revisions, bone loss is one of the problems that need to be addressed intraoperatively, and a firm fixation. The reconstruction options for bone loss include bone cement filling, screw-reinforced bone cement, metal reinforcement, autologous bone grafting, allogeneic bone grafting, and the porous cones and porous-coated sleeves [4, 6,7,8,9]. The best strategy for reconstructing significant metaphyseal bone loss during TKA revisions has not been established. The modular cementless metaphyseal fixation has been successfully introduced into revision (2020) 2:12. Porous-coated metaphyseal sleeves are designed to fill bone loss and facilitate osseo-integration when bone loss occurs during revision total knee arthroplasty (TKA).

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