Clinical Orthopaedics and Related Research®

, Volume 470, Issue 3, pp 735–742

Aseptic Failure: How Does the Compress® Implant Compare to Cemented Stems?

  • Andrew C. Pedtke
  • Rosanna L. Wustrack
  • Andrew S. Fang
  • Robert J. Grimer
  • Richard J. O’Donnell
Symposium: 2010 Musculoskeletal Tumor Society

DOI: 10.1007/s11999-011-2159-5

Cite this article as:
Pedtke, A.C., Wustrack, R.L., Fang, A.S. et al. Clin Orthop Relat Res (2012) 470: 735. doi:10.1007/s11999-011-2159-5



Failure of endoprosthetic reconstruction with conventional stems due to aseptic loosening remains a challenge for maintenance of limb integrity and function. The Compress® implant (Biomet Inc, Warsaw, IN, USA) attempts to avoid aseptic failure by means of a unique technologic innovation. Though the existing literature suggests survivorship of Compress® and stemmed implants is similar in the short term, studies are limited by population size and followup duration.


We therefore compared (1) the rate of aseptic failure between Compress® and cemented intramedullary stems and (2) evaluated the overall intermediate-term implant survivorship.


We reviewed 26 patients with Compress® implants and 26 matched patients with cemented intramedullary stems. The patients were operated on over a 3-year period. Analysis focused on factors related to implant survival, including age, sex, diagnosis, infection, aseptic loosening, local recurrence, and fracture. Minimum followup was 0.32 years (average, 6.2 years; range, 0.32–9.2 years).


Aseptic failure occurred in one (3.8%) patient with a Compress® implant and three (11.5%) patients with cemented intramedullary stems. The 5-year implant survival rate was 83.5% in the Compress® group and 66.6% in the cemented intramedullary stem group.


The Compress® implant continues to be a reliable option for distal femoral limb salvage surgery. Data regarding aseptic failure is encouraging, with equivalent survivorship against cemented endoprosthetic replacement at intermediate-term followup.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • Andrew C. Pedtke
    • 1
  • Rosanna L. Wustrack
    • 1
  • Andrew S. Fang
    • 2
  • Robert J. Grimer
    • 3
  • Richard J. O’Donnell
    • 4
  1. 1.Department of Orthopaedic SurgeryUniversity of California San FranciscoSan FranciscoUSA
  2. 2.Department of Orthopedic SurgeryThe Permanente Medical GroupSouth San FranciscoUSA
  3. 3.Royal Orthopaedic Hospital NHS TrustBirminghamUK
  4. 4.Orthopaedic Oncology Service, UCSF Helen Diller Family Comprehensive Cancer CenterSan FranciscoUSA

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