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