Your browser doesn't support javascript.
loading
A Prophylactic Tibial Stem Reduces Rates of Early Aseptic Loosening in Patients with Severe Preoperative Varus Deformity in Primary Total Knee Arthroplasty.
Hegde, Vishal; Bracey, Daniel N; Brady, Anna C; Kleeman-Forsthuber, Lindsay T; Dennis, Douglas A; Jennings, Jason M.
Afiliação
  • Hegde V; Colorado Joint Replacement, Denver, CO; Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD.
  • Bracey DN; Colorado Joint Replacement, Denver, CO; Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, NC.
  • Brady AC; Colorado Joint Replacement, Denver, CO.
  • Kleeman-Forsthuber LT; Colorado Joint Replacement, Denver, CO.
  • Dennis DA; Colorado Joint Replacement, Denver, CO; Department of Mechanical and Materials Engineering, University of Denver, Denver, CO; Department of Orthopaedics, University of Colorado School of Medicine, Denver, CO; Department of Biomedical Engineering, University of Tennessee, Knoxville, TN.
  • Jennings JM; Colorado Joint Replacement, Denver, CO; Department of Mechanical and Materials Engineering, University of Denver, Denver, CO.
J Arthroplasty ; 36(7): 2319-2324, 2021 07.
Article em En | MEDLINE | ID: mdl-33583669
ABSTRACT

BACKGROUND:

Patients with a preoperative varus deformity >8 degrees are at increased risk of aseptic loosening after total knee arthroplasty. This study analyzes the effect of a tibial stem on the rate of aseptic loosening in patients with a severe preoperative varus deformity.

METHODS:

Patients with a preoperative varus deformity of >8 degrees and 2-year minimum follow-up with a stemmed tibial component (n = 67) were matched 12 to patients with a similar preoperative varus deformity with a standard tibial component (n = 134). Radiolucent lines were measured on the tibia at 6 weeks, 1 year, and 2 years postoperatively using the Knee Society Radiographic Evaluation System. Failure was defined as revision due to aseptic loosening of the tibial component. Outcomes were evaluated using Student's t-tests and log-rank tests.

RESULTS:

Patients with tibial stems had greater preoperative deformity (12.9 vs 11.3 degrees, P = .004). There was no difference in postoperative alignment (1.7 vs 2.1 degrees varus, P = .25) or tibial component angle (1.8 vs 2.1 degrees varus, P = .33). Patients with stems were more likely to have more constraint (44.8% vs 1.5%, P < .001). Progression of radiolucent lines >2 mm was observed in 17.6% (23/134) vs 5.97% (4/67) of patients in the stem group (P = .03). Rates of aseptic loosening were lower in the stem group (0% vs 5.15%, P = .05).

CONCLUSION:

Despite worse preoperative deformity and higher utilization of constraint, tibial stem use in patients with severe preoperative varus deformity resulted in lower rates of aseptic loosening. Prophylactic use of stems in these patients may help increase implant survival.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Artroplastia do Joelho / Prótese do Joelho Tipo de estudo: Observational_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Artroplastia do Joelho / Prótese do Joelho Tipo de estudo: Observational_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article