The Journal of Arthroplasty, Volume 35, Issue 2, 495 - 499

Metaphyseal Sleeves in Revision Total Knee Arthroplasty Provide Reliable Fixation and Excellent Medium to Long-Term Implant Survivorship

Bloch, Benjamin V. et al.
Knee

Background

Addressing 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.

Methods

We 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.

Results

Implant 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.

Conclusion

Use 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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