Cargando…
Mid-term clinical and radiographic outcomes of porous-coated metaphyseal sleeves used in revision total knee arthroplasty
BACKGROUND: The management of bone defects remains one of the major challenges surgeons are faced with in revision total knee arthroplasty (RTKA). Large and uncontained bone defects are traditionally managed with metaphyseal sleeves that facilitate osseointegration and have reported construct stabil...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097806/ https://www.ncbi.nlm.nih.gov/pubmed/33947470 http://dx.doi.org/10.1186/s43019-021-00103-5 |
_version_ | 1783688387678437376 |
---|---|
author | Gurel, Ron Morgan, Samuel Elbaz, Etay Ashlenazi, Itay Snir, Nimrod Kadar, Assaf Gold, Aviram Warschawski, Yaniv |
author_facet | Gurel, Ron Morgan, Samuel Elbaz, Etay Ashlenazi, Itay Snir, Nimrod Kadar, Assaf Gold, Aviram Warschawski, Yaniv |
author_sort | Gurel, Ron |
collection | PubMed |
description | BACKGROUND: The management of bone defects remains one of the major challenges surgeons are faced with in revision total knee arthroplasty (RTKA). Large and uncontained bone defects are traditionally managed with metaphyseal sleeves that facilitate osseointegration and have reported construct stability. While many studies have presented excellent short-term outcomes using metaphyseal sleeves, less is known on their performance in the longer term. The purpose of this study was to present our mid-term results of the metaphyseal sleeves used in patients undergoing RTKA. MATERIALS AND METHODS: Between January 2007 and January 2015, 30 patients underwent RTKA with the use of a CCKMB prosthesis combined with an osteointegrative sleeve. The main indications for RTKA were instability in 40% of the cases (n = 12), aseptic loosening in 30% (n = 9), infection in 26.7% (n = 8), and “other” in 3.3% (n = 1). The minimal follow-up time was 5 years and the mean follow-up time was 82.4 months (SD = 22.6). Clinical outcomes were assessed by Knee Society scores (KSS), range of motion and rate of re-operation. RESULTS: The mean Knee Society score increased significantly from 72.1 preoperatively to 90.0 postoperatively (p < 0.001). The cumulative incidence of re-operation in our study was 13.3% (n = 4). Our study reported no cases of aseptic loosening or mobile-bearing spin-out. Knee flexion to 90° and more was impossible in seven cases (23.3%) preoperatively and in one case (3.3%) postoperatively. CONCLUSION: Porous-coated metaphyseal sleeves demonstrated excellent rates of survivorship and radiographic ingrowth in the mid-term setting. However, further studies are required to assess their outcomes in the long-term. |
format | Online Article Text |
id | pubmed-8097806 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-80978062021-05-06 Mid-term clinical and radiographic outcomes of porous-coated metaphyseal sleeves used in revision total knee arthroplasty Gurel, Ron Morgan, Samuel Elbaz, Etay Ashlenazi, Itay Snir, Nimrod Kadar, Assaf Gold, Aviram Warschawski, Yaniv Knee Surg Relat Res Research Article BACKGROUND: The management of bone defects remains one of the major challenges surgeons are faced with in revision total knee arthroplasty (RTKA). Large and uncontained bone defects are traditionally managed with metaphyseal sleeves that facilitate osseointegration and have reported construct stability. While many studies have presented excellent short-term outcomes using metaphyseal sleeves, less is known on their performance in the longer term. The purpose of this study was to present our mid-term results of the metaphyseal sleeves used in patients undergoing RTKA. MATERIALS AND METHODS: Between January 2007 and January 2015, 30 patients underwent RTKA with the use of a CCKMB prosthesis combined with an osteointegrative sleeve. The main indications for RTKA were instability in 40% of the cases (n = 12), aseptic loosening in 30% (n = 9), infection in 26.7% (n = 8), and “other” in 3.3% (n = 1). The minimal follow-up time was 5 years and the mean follow-up time was 82.4 months (SD = 22.6). Clinical outcomes were assessed by Knee Society scores (KSS), range of motion and rate of re-operation. RESULTS: The mean Knee Society score increased significantly from 72.1 preoperatively to 90.0 postoperatively (p < 0.001). The cumulative incidence of re-operation in our study was 13.3% (n = 4). Our study reported no cases of aseptic loosening or mobile-bearing spin-out. Knee flexion to 90° and more was impossible in seven cases (23.3%) preoperatively and in one case (3.3%) postoperatively. CONCLUSION: Porous-coated metaphyseal sleeves demonstrated excellent rates of survivorship and radiographic ingrowth in the mid-term setting. However, further studies are required to assess their outcomes in the long-term. BioMed Central 2021-05-04 /pmc/articles/PMC8097806/ /pubmed/33947470 http://dx.doi.org/10.1186/s43019-021-00103-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Gurel, Ron Morgan, Samuel Elbaz, Etay Ashlenazi, Itay Snir, Nimrod Kadar, Assaf Gold, Aviram Warschawski, Yaniv Mid-term clinical and radiographic outcomes of porous-coated metaphyseal sleeves used in revision total knee arthroplasty |
title | Mid-term clinical and radiographic outcomes of porous-coated metaphyseal sleeves used in revision total knee arthroplasty |
title_full | Mid-term clinical and radiographic outcomes of porous-coated metaphyseal sleeves used in revision total knee arthroplasty |
title_fullStr | Mid-term clinical and radiographic outcomes of porous-coated metaphyseal sleeves used in revision total knee arthroplasty |
title_full_unstemmed | Mid-term clinical and radiographic outcomes of porous-coated metaphyseal sleeves used in revision total knee arthroplasty |
title_short | Mid-term clinical and radiographic outcomes of porous-coated metaphyseal sleeves used in revision total knee arthroplasty |
title_sort | mid-term clinical and radiographic outcomes of porous-coated metaphyseal sleeves used in revision total knee arthroplasty |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097806/ https://www.ncbi.nlm.nih.gov/pubmed/33947470 http://dx.doi.org/10.1186/s43019-021-00103-5 |
work_keys_str_mv | AT gurelron midtermclinicalandradiographicoutcomesofporouscoatedmetaphysealsleevesusedinrevisiontotalkneearthroplasty AT morgansamuel midtermclinicalandradiographicoutcomesofporouscoatedmetaphysealsleevesusedinrevisiontotalkneearthroplasty AT elbazetay midtermclinicalandradiographicoutcomesofporouscoatedmetaphysealsleevesusedinrevisiontotalkneearthroplasty AT ashlenaziitay midtermclinicalandradiographicoutcomesofporouscoatedmetaphysealsleevesusedinrevisiontotalkneearthroplasty AT snirnimrod midtermclinicalandradiographicoutcomesofporouscoatedmetaphysealsleevesusedinrevisiontotalkneearthroplasty AT kadarassaf midtermclinicalandradiographicoutcomesofporouscoatedmetaphysealsleevesusedinrevisiontotalkneearthroplasty AT goldaviram midtermclinicalandradiographicoutcomesofporouscoatedmetaphysealsleevesusedinrevisiontotalkneearthroplasty AT warschawskiyaniv midtermclinicalandradiographicoutcomesofporouscoatedmetaphysealsleevesusedinrevisiontotalkneearthroplasty |