Results of Press-fit Stems in Revision Knee Arthroplasties

• Published in: Clinical orthopaedics and related research Vol. 467; no. 3; pp. 810 - 817
• Main Authors: Wood, Gavin C., Naudie, Douglas D. R., MacDonald, Steven J., McCalden, Richard W., Bourne, Robert B.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01-03-2009; Springer; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - instrumentation; Biological and medical sciences; Bone Cements - therapeutic use; Conservative Orthopedics; Diaphyses - surgery; Diseases of the osteoarticular system; Female; Humans; Kaplan-Meier Estimate; Knee Joint - diagnostic imaging; Knee Joint - surgery; Knee Prosthesis; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Original; Original Article; Orthopedics; Prosthesis Design; Prosthesis Failure; Radiography; Reoperation; Retrospective Studies; Sports Medicine; Surgery; Surgical Orthopedics; Time Factors; Titanium; Treatment Outcome; Aseptic Loosening; Medial Collateral Ligament; Knee Society Score; Knee Score; Tibial Component; Press-fit system; Reoperation; Knee arthroplasty; Orthopedics; Stem
• ISSN: 0009-921X; 1528-1132
• DOI: 10.1007/s11999-008-0621-9

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.