Effect of Stem Size and Fixation Method on Mechanical Failure After Revision Total Knee Arthroplasty.
J Arthroplasty
; 32(9S): S202-S208.e1, 2017 09.
Article
em En
| MEDLINE
| ID: mdl-28559193
ABSTRACT
BACKGROUND:
Although the need for stemmed components is well accepted to improve mechanical survival in revision total knee arthroplasty (TKA), the ideal fixation method and stem design remain controversial.METHODS:
We performed a retrospective review of 223 patients who underwent revision TKA in whom stemmed components had not been used previously and with a mean follow-up of 61.6 months, including 108 components with fully cemented stems and 316 components with "hybrid" press-fit stems.RESULTS:
Based on a time to event model, risk for mechanical failure was equivalent for both cemented and hybrid stems (relative risk, 0.991; P = .98). Young age was the single greatest risk factor for mechanical failure (P = .006). Although there was a trend toward increased failure with cemented stems in patients aged <65 years, there was no significant difference in risk after accounting for covariates (relative risk, 1.4; P = .50). Intramedullary canal fill, not stem length or diameter, was the strongest predictor of failure with hybrid stems, and risk was reduced by 41.2% for each additional 10% canal fill.CONCLUSION:
In conclusion, both cemented and hybrid modular stems are viable options in revision TKA. Surgeons should attempt to maximize canal filling of hybrid stems to obtain a solid press-fit. In addition, further studies are needed to evaluate the long-term survival of cemented stem fixation in young patients.Palavras-chave
Texto completo:
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Bases de dados:
MEDLINE
Assunto principal:
Reoperação
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Artroplastia do Joelho
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Prótese do Joelho
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Arthroplasty
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2017
Tipo de documento:
Article