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

  • Symposium: 2010 Musculoskeletal Tumor Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

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.

Questions/purposes

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

Methods

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).

Results

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.

Conclusions

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.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA

    Andrew C. Pedtke MD & Rosanna L. Wustrack MD

  2. Department of Orthopedic Surgery, The Permanente Medical Group, South San Francisco, CA, USA

    Andrew S. Fang MD

  3. Royal Orthopaedic Hospital NHS Trust, Birmingham, UK

    Robert J. Grimer FRCS

  4. Orthopaedic Oncology Service, UCSF Helen Diller Family Comprehensive Cancer Center, 1600 Divisadero Street, 4th Floor, San Francisco, CA, 94115-1939, USA

    Richard J. O’Donnell MD

Authors
  1. Andrew C. Pedtke MD
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  2. Rosanna L. Wustrack MD
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  3. Andrew S. Fang MD
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  4. Robert J. Grimer FRCS
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  5. Richard J. O’Donnell MD
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Corresponding author

Correspondence to Richard J. O’Donnell MD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use.

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

This work was performed at the University of California San Francisco, the Royal Orthopaedic Hospital, and the Kaiser Permanente South San Francisco Medical Center.

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Pedtke, A.C., Wustrack, R.L., Fang, A.S. et al. Aseptic Failure: How Does the Compress® Implant Compare to Cemented Stems?. Clin Orthop Relat Res 470, 735–742 (2012). https://doi.org/10.1007/s11999-011-2159-5

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  • DOI: https://doi.org/10.1007/s11999-011-2159-5

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