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Results of Press-fit Stems in Revision Knee Arthroplasties

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Clinical Orthopaedics and Related Research

Abstract

The ideal method of stem fixation in revision knee arthroplasty is controversial with advantages and disadvantages for cemented and press-fit designs. Studies have suggested cemented revision knee stems may provide better long-term survival. The aim of this study was to report our experience with press-fit uncemented stems and metaphyseal cement fixation in a selected series of patients undergoing revision total knee arthroplasty. One hundred twenty-seven patients (135 knees) who underwent revision total knee arthroplasty using a press-fit technique (press-fit diaphyseal fixation and cemented metaphyseal fixation) were reviewed. Minimum followup was 2 years (mean, 5 years; range, 2–12 years). A Kaplan–Meier survivorship analysis using an end point of revision surgery or radiographic loosening was used to determine probability of survival at 5 and 10 years. Of the 127 patients (135 knees), 31 patients (36 knees) died and two patients (two knees) were lost to followup. Six patients (six knees) had revisions at a mean of 3.5 years (range, 1–8 years). Kaplan–Meier survivorship analysis revealed a probability of survival free of revision for aseptic loosening of 98% at 12 years. Survivorship of press-fit stems for revision knee arthroplasty is comparable to reported survivorship of cemented stem revision knee arthroplasty. Radiographic analysis has shown continued satisfactory appearances regardless of constraint, stem size, and augmentations.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Department of Surgery (Orthopaedics), Kingston General Hospital, Queens University, Victory 3, Room 315, Stuart Street, Kingston, ON, Canada, K7L 2V7

    Gavin C. Wood FRCS

  2. Department of Surgery (Orthopaedics), London Health Sciences Centre, University of Western Ontario, University Campus, A9-028, 339 Windermere Road, London, ON, Canada, N6A5A5

    Douglas D. R. Naudie MD, FRCSC

  3. Department of Surgery (Orthopaedics), London Health Sciences Centre, University of Western Ontario, University Campus, 339 Windermere Road, London, ON, Canada, N6A5A5

    Steven J. MacDonald MD, FRCSC, Richard W. McCalden MD, FRCSC & Robert B. Bourne MD, FRCSC

Authors
  1. Gavin C. Wood FRCS
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  2. Douglas D. R. Naudie MD, FRCSC
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  3. Steven J. MacDonald MD, FRCSC
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  4. Richard W. McCalden MD, FRCSC
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  5. Robert B. Bourne MD, FRCSC
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Corresponding author

Correspondence to Douglas D. R. Naudie MD, FRCSC.

Additional information

One or more of the authors (DDRN, SJM, RWM, RBB) have received funding from Smith & Nephew, DePuy, and Stryker.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that Institutional Review Board approval for this study was obtained.

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Wood, G.C., Naudie, D.D.R., MacDonald, S.J. et al. Results of Press-fit Stems in Revision Knee Arthroplasties. Clin Orthop Relat Res 467, 810–817 (2009). https://doi.org/10.1007/s11999-008-0621-9

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  • DOI: https://doi.org/10.1007/s11999-008-0621-9

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