Custom-Made Cement-Linked Distal Femoral Replacement for Interprosthetic Femur Fractures: Five-Year Follow-Up

Matar, Hosam E; Stritch, Paula; Emms, Nicholas

doi:10.1615/jlongtermeffmedimplants.2018026502

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“…The system used is versatile offering different femoral options to the tibial tray from semi-constrained to fully constrained (hinge) and distal femoral replacement. In this cohort with minimal metaphyseal bone loss, we find a short-cemented stem femoral construct an effective strategy offering immediate stability, shorter construct particularly important with the rise of interprosthetic fractures in the presence of ipsilateral hip prosthesis [27,28], and reduces cost. If surgeons are concerned about the possibility of component malalignment with a short stem, we would suggest routinely trialing and preparing using a longer trial construct.…”

Section: Discussionmentioning

confidence: 86%

High Survivorship of Short-Cemented Femoral Stems in Condylar Revision Total Knee Arthroplasty Without Significant Metaphyseal Bone Loss: Minimum 5-Year Follow-Up

Matar

Bloch

James

2021

The Journal of Arthroplasty

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Background: We aimed to evaluate the outcomes of hybrid fixation technique in condylar revision total knee arthroplasty (rTKA) using cementless metaphyseal tibial sleeves and short-cemented femoral stems with a rotating platform articulation. Methods: Retrospective consecutive study of all condylar rTKAs with a cemented femoral stem between 2009 and 2016 was conducted. Patients were identified using a local prospective database and linkable data obtained from the National Joint Registry for rTKA. Demographic, clinical, and surgical data were collected from patients' electronic health records. The primary outcome measure was mechanical failure and implant survivorship using a nationally collected data, complications, re-operations, and "any-cause revision" were also recorded. Results: There were 72 consecutive patients (72 knees) with minimum 5-year follow-up: 33 (45.8%) females and 39 (54.2%) males with a median age of 70 years (range 47-88). The indication for revision surgery was aseptic loosening (n ¼ 34, 47.2%), instability (n ¼ 17, 23.6%), infection (n ¼ 14, 19.5%) with 10 patients having 2-stage approach and 4 patients with single-stage approach, stiffness (n ¼ 4, 5.6%), and malalignment (n ¼ 3, 4.1%). At mean follow-up of 6.87 years (median 6.7; range 5-11.8), only 2 patients required revision for infection. Using "any-cause implant revision" as an end point, implant survivorship for this construct was 97.2% at median 6.7 years. To date, none of the femoral stems have been revised for mechanical failure. Conclusion:In rTKA with good femoral condylar bone stock, we have shown excellent survivorship with a short-cemented femoral stem, in conjunction with a mobile-bearing and a tibial sleeve. This has the advantage of reducing the length of the revision construct of this complex surgery.

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Section: Discussionmentioning

confidence: 86%