Metaphyseal Sleeves in Revision Total Knee Arthroplasty Provide Reliable Fixation and Excellent Medium to Long-Term Implant Survivorship |
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| Affiliation: | 1. Nottingham Elective Orthopaedic Services, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom;2. Department of Trauma and Orthopaedics, Northampton General Hospital NHS Trust, Northampton, United Kingdom;3. Department of Trauma & Orthopaedics, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom;4. Exeter Knee Reconstruction Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon & Exeter Hospitals NHS Trust, Exeter, United Kingdom;1. Department of Orthopaedic Surgery, Kobe Kaisei Hospital, Nada, Kobe, Japan;2. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo, Kobe, Japan;1. Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, NY;2. Department of Biomechanics, Hospital for Special Surgery, Newyork, NY;1. Department of Trauma & Orthopaedics, University Hospital, Llandough, Cardiff, United Kingdom;2. University of Cardiff, Cardiff, United Kingdom;1. Department for Joint Replacement and Restoration, Diakovere Annastift Hannover, Hannover, Germany;2. Department for Joint Replacement and Restoration, Paracelsus-Klinik am Silbersee Hannover-Langenhagen, Langenhagen, Germany;1. Department of Orthopaedic Surgery, University of Louisville, Louisville, KY;2. University of Louisville School of Medicine, Louisville, KY;3. Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH;4. Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL;5. Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, NY;6. University of Louisville, Adult Reconstruction Program, KentuckyOne Health, Louisville, KY |
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| Abstract: | BackgroundAddressing bone loss and securing implant fixation can be challenging in revision total knee arthroplasty (TKA). We present the results of a large series of revision TKAs using a metaphyseal sleeve.MethodsWe retrospectively analyzed 319 revision TKAs with the use of a metaphyseal sleeve that had been followed up for at least 2 years, using a prospectively collected database. The mean follow-up was 91 months, and 73 patients were followed up for more than 10 years.ResultsImplant survivorship was 99.1% at 3 years, 98.7% at 5 years, and 97.8% at 10 years. No metaphyseal sleeve was revised for aseptic loosening. Final radiographic review showed that there were radiolucent lines present in 2.8% of tibial sleeves and 2.7% of femoral sleeves; none of these had progressed and none were revised. About 3.7% of tibial sleeves subsided more than 1 mm compared with the immediate postoperative X-ray but all stabilized and none were revised.ConclusionUse of a metaphyseal sleeve in revision TKA is associated with excellent survivorship and radiographic outcome in the medium to long term. |
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| Keywords: | revision total knee arthroplasty metaphyseal sleeves outcome implant survivorship fixation bone loss |
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