Revision Total Knee Arthroplasty with Metaphyseal Sleeves without Stem: Short-Term Results

Abstract

Purpose The aim of this study was to evaluate the efficacy of revision total knee arthroplasty (TKA) with cementless metaphyseal sleeves without stems either in the femoral or tibial side or in both. Methods In this retrospective study, 51 patients (51 knees) operated in the period 2010 to 2015 met the above-mentioned criteria and were invited to a medical examination including X-rays. Forty-six were available for the study. Mean follow-up was 37 months. Knee Society score (KSS) (objective knee score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and range of motion (ROM) were used as outcome scores and compared with baseline values. X-rays were also examined and compared with postoperative exams to evaluate the presence of loosening, radiolucent lines, and bone ingrowth. Satisfaction of the patients was also investigated using a linear scale from 1 to 10. Results KSS improved from 39 to 77 ( p < 0.01); WOMAC score improved from 76 to 41 ( p < 0.01). Twenty-four (52%) patients were satisfied, 15 (32%) were partially satisfied, and 7 (16%) were unsatisfied. ROM improved from 93 to 96 degrees (nonsignificant difference). X-rays showed no loosening of the implants, radiolucent lines in 4 patients (3 of them were asymptomatic) and bone ingrowth in 43 out of 46 patients. Conclusion In this short-term retrospective study, the use of sleeves without stem was a safe and effective procedure in revision TKA. We found a significant improvement in clinical results compared with baseline values and no signs of implant loosening. Level of Evidence Level IV, therapeutic case series.

Cementless Metaphyseal Sleeve Fixation in Revision Knee Arthroplasty: Our Experience with an Arabic Population at the Midterm

“…To the best of our knowledge, ours is the first report on the use of MS in RKA of Arabic patients. The female predominance in our cohort has been observed in other series and was attributed to postmenopausal osteoporosis [ 31 , 32 ]. We believe that this is a reflection of the higher percentage of primary TKA in our female patients as compared to their male counterparts.…”

Tibial metaphyseal cones combined with short stems perform as well as long stems in revision total knee arthroplasty

“…13,36 The current literature surrounding optimal stem use in rTKA, let alone TM Cone utilizing rTKA, is poor. 37 MS implants without long stems have shown mixed results; Stefani et al 38 and Fonesca et al 39 reported favourable outcomes whereas Gøttsche et al 40 encountered problems with implant malalignment. In contrast, TM cones without long stems have demonstrated consistently promising outcomes.…”

Failure of the femoral stem – condyle junction in a semiconstrained knee prosthesis. Analysis of two cases

“…The TC3 implant (Depuy Synthes) has been used for many years as both a primary and revision implant with good clinical results in short-term [13][14][15][16][17] and long-term [18] observation. Damage of the prosthesis at the level of stem -condyle junction is a rare phenomenon, but it is described in the literature and carries serious consequences for the patient [6].…”