Metaphyseal sleeves in revision total knee arthroplasty: Minimum seven-year follow-up study

Agarwal, Sanjeev; Neogi, Devdatta Suhas; Morgan–Jones, Rhidian

doi:10.1016/j.knee.2018.09.010

Cited by 38 publications

(27 citation statements)

References 22 publications

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“…Porous titanium metaphyseal sleeves with a stepped shape and titanium bead coating were easy to use for fixation by bone ingrowth and were available to fill the metaphyseal defects. The femoral component was attached to the sleeve through the Morse junction on the instrument[13]. Although many authors recommended the use of cement in combination with screws in cases of contained or uncontained defects between 5 mm and 10 mm, we still used the cement to reconstruct the massive defects of the lateral femoral condyle.…”

Section: Discussionmentioning

confidence: 99%

Re-revision surgery for re-recurrent valgus deformity after revision total knee arthroplasty in a patient with a severe valgus deformity: A case report

Du¹,

Sun²,

Ni³

et al. 2019

WJCC

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BACKGROUNDA recurrent valgus deformity was a common complication after total knee arthroplasty (TKA) in patients with valgus deformity. However, re-revision surgery for re-recurrent valgus deformity after revision TKA in patients with valgus deformity before primary TKA was uncommon.CASE SUMMARYWe reported a 72-year-old female patient with two recurrent valgus deformities after TKA for a valgus knee deformity who underwent two revision surgeries to rectify the deformity. In the re-revision surgery, bone defects were successfully reconstructed by the augments and cement in combination with screws and a sleeve. An appropriate neutral alignment of the lower limb was restored by the perfect femoral entry point and the long diaphyseal cementless stem. Adequate fixation of the metaphysis and diaphysis of the femur was obtained by the sleeve and long diaphyseal cementless stem. The patient was pain-free and deformity-free for 2.5 years.CONCLUSIONThe management of bone defects, the choice of the stem and the femoral entry point were of vital importance in the revision or re-revision TKA for a recurrent valgus deformity.

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Section: Discussionmentioning

confidence: 99%

Re-revision surgery for re-recurrent valgus deformity after revision total knee arthroplasty in a patient with a severe valgus deformity: A case report

Du¹,

Sun²,

Ni³

et al. 2019

WJCC

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“…6)). Sleeves zeigen hervorragende kurz-bis mittelfristige Ergebnisse (Lockerungsraten von 2 % nach 3,6 Jahren [31], 7 % nach 7 Jahren [32]).…”

Section: Biologischer Defektaufbauunclassified

“…Verbliebene Defekte können bei guter Stabilität des Sleeves knöchern augmentiert werden (▶ Abb. 5).Sleeves zeigen hervorragende kurz-bis mittelfristige Ergebnisse (Lockerungsraten von 2 % nach 3,6 Jahren [31], 7 % nach 7 Jahren[32]). Ob unter Verwendung eines Sleeves ganz auf eine diaphysäre Verankerung verzichtet werden kann, ist aktuell noch in der Diskussion.…”

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Revisionsendoprothetik des Kniegelenks

Kremer¹,

Gramlich²,

Hoffmann³

2020

Z Orthop Unfall

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ZusammenfassungDie Kombination aus steigender Lebenserwartung, Zunahme der Risikofaktoren für eine Gonarthrose gepaart mit hohem funktionellem Anspruch bis ins hohe Lebensalter führt zu einer Zunahme der Implantationszahlen primärer Knieendoprothesen. Folglich nimmt auch die Häufigkeit von Revisionseingriffen drastisch zu. Klare Konzepte sind notwendig, um gute Ergebnisse zu erzielen. Dieser Artikel gibt einen Überblick über die aktuellen Strategien der Revisionsendoprothetik des Kniegelenks.

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“…Use of metaphyseal sleeves for revision knee arthroplasty, especially those with bone loss, has been shown to have very good short-and medium-term results. [18][19][20][21][22][23][24][25] Their use has been suggested to be effective in the setting of infection following knee arthroplasty, particularly in providing stable fixation of implants and contributing to the overall debridement. This cohort study was designed to evaluate their use for this indication.…”

Section: Surgical Techniquementioning

confidence: 99%

Results of Using a “2-in-1” Single-Stage Revision Total Knee Arthroplasty for Infection with Associated Bone Loss: Prospective 2-Year Follow-Up

et al. 2019

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Objective Prosthetic joint infections provide a complex challenge for management, owing to their often difficult diagnoses, need for multiple surgeries, and increased technical and financial requirements. The ‘2 in 1’ single-stage approaches have been recently advocated in the field of arthroplasty on account of their reduction in risks, costs, and complications. The aim of our study was to investigate the outcomes of this variant of single-stage revision, which is used in the setting of infection following primary total knee replacement (TKR) and associated bone loss. Methods Prospective data were collected from all patients presenting with an infection following primary TKR over an 8-year period (2009–2017). We examined revision procedures that were undertaken as a single-stage procedure and had bone loss present. Patients were followed-up for evidence of recurrent infection. Functional assessments were conducted using range of motion, Oxford Knee Score (OKS), American Knee Society Score (AKSS), and Short Form-12 (SF-12) survey. Results Twenty-six patients were included in the analysis, two of whom had previously failed 2 stage revision; another three among them had failed debridement, antibiotics, irrigation, and implant retention procedures. The mean age was 72.5 years, mean body mass index was 33.4, and median American Society of Anesthesiologists (ASA) physical status classification was 2. The mean time to revision was 3.5 years (3 months to 12 years). Six patients had actively been discharging sinuses at the time of surgery. Only 4/26 patients possessed no positive microbiological cultures from deep tissue samples or joint aspirates. One patient was afflicted with a recurrence of infection. This patient did not require further surgery and was successfully treated with the help of long-term antibiotic suppression. There were statistically significant improvements in both the pain component of AKSS scores (preoperative 4.3 to postoperative 32.4) and the functional component of AKSS scores (preoperative 10.7 to postoperative 15.7). There was no significant improvement in flexion; however, mean extension (increased from 18.5 to 6.9 postoperative) and total range of motion (increased from 69.2 preoperative to 90.3 postoperative) both showed statistically significant improvements. Conclusion The use of “2-in-1” single-stage revision can be considered as an effective option for treating infection following TKR and associated bone loss.

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Metaphyseal sleeves in revision total knee arthroplasty: Minimum seven-year follow-up study

Cited by 38 publications

References 22 publications

Re-revision surgery for re-recurrent valgus deformity after revision total knee arthroplasty in a patient with a severe valgus deformity: A case report

Re-revision surgery for re-recurrent valgus deformity after revision total knee arthroplasty in a patient with a severe valgus deformity: A case report

Revisionsendoprothetik des Kniegelenks

Results of Using a “2-in-1” Single-Stage Revision Total Knee Arthroplasty for Infection with Associated Bone Loss: Prospective 2-Year Follow-Up

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