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

Metal metaphyseal sleeves are an option for reconstruction as well as enhancing fixation in managing challenging bone defects in revision knee replacement. We report our results of revision knee replacement using metaphyseal sleeves with a minimum of seven years of follow-up. The records of 103 pati...

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Bibliographic Details
Published in:The knee 2018-12, Vol.25 (6), p.1299-1307
Main Authors: Agarwal, Sanjeev, Neogi, Devdatta Suhas, Morgan-Jones, Rhidian
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arthroplasty
Arthroplasty (knee)
Arthroplasty, Replacement, Knee - adverse effects
Arthroplasty, Replacement, Knee - instrumentation
Arthroplasty, Replacement, Knee - methods
Bone implants
Cement
Defects
Female
Follow-Up Studies
Humans
Joint surgery
Knee
Knee Joint - surgery
Knee Prosthesis - adverse effects
Male
Metaphyseal sleeve
Middle Aged
Midterm
Pain
Prospective Studies
Prosthesis Design - adverse effects
Prosthesis Failure - adverse effects
Reoperation - adverse effects
Reoperation - instrumentation
Reoperation - methods
Replacement
Revision
Sleeve
Surgery
Survival Analysis
Transplants & implants
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Summary:Metal metaphyseal sleeves are an option for reconstruction as well as enhancing fixation in managing challenging bone defects in revision knee replacement. We report our results of revision knee replacement using metaphyseal sleeves with a minimum of seven years of follow-up. The records of 103 patients (104 knees) who underwent revision knee replacement using metaphyseal sleeves in our centre were evaluated. The follow-up included clinical assessment, functional scores and radiologic assessment. The mean age of patients was 74.7 (tange 58-92) years. Mean follow-up was 95.7 (range, 88–115) months. From the original cohort, 15 (14%) patients had died from unrelated causes. During the follow-up period, there were 23 (22.1%) re-revisions. Indications for re-revision was aseptic loosening in seven (6.7%), stiffness in four (3.8%), infection in five (4.8%), instability in three (2.8%) and persistent pain in two (1.9%) patients. For aseptic loosening, the average time for re-revisions was 56.6 months (range 25 to 84). Radiographically, all unrevised sleeves were well-fixed, without any evidence of loosening. Oxford knee score in patients without re-revisions was 28.5 (range four to 48). At mid-term follow-up, metaphyseal sleeves demonstrate durable clinical results and radiographic fixation.
ISSN:0968-0160
1873-5800
DOI:10.1016/j.knee.2018.09.010