The Knee, ISSN: 1873-5800, Vol: 23, Issue: 3, Page: 545-8

The use of metaphyseal sleeves in revision total knee arthroplasty

Dalury, David F; Barrett, William P
Knee

Highlights

  • Tibial bone loss is a common finding in the setting of revision TKA.
  • The reconstruction of this bone loss is an important goal of revision surgery.
  • Various options are available to reconstruct this bone loss.
  • Metaphyseal sleeves are an effective alternative for bone loss reconstruction.

Abstract

Background

Bone loss in revision total knee arthroplasty is common. Various reconstruction options are available. The purpose of our study is to report on one such reconstruction option, titanium metaphyseal sleeves.

Methods

We describe a series of 45 patients (46 knees) who underwent revision total knee arthroplasty and were treated with a porous metaphyseal sleeve between August 2000 and September 2009 at two centers. Patients were followed for a minimum of four years, and at final follow-up, 40 patients (40 knees) were available for review. Patients were evaluated using The Knee Society’s Knee Scoring System at each follow-up. Radiographs (standing anteroposterior, lateral, and sunrise views) were taken at six weeks, three months, and final evaluations.

Results

Mean Knee Society Scores increased from 36 (range 10 to 69) pre-operatively to 90 (range 38 to 100) at final follow-up. Mean alignment on final radiographic evaluation was 5° (range 3° to 8° valgus). Mean pre-operative alignment was 6° (range 15° varus to 18° valgus). Mean range of motion was 125° (range 80° to 140°) pre-operatively and 115° (range 95° to 130°) postoperatively. One device failed to achieve ingrowth and was revised at two years. All other knees were radiographically stable and ingrown.

Conclusions

Metaphyseal sleeves provide an alternative for bone loss reconstruction in revision total knee arthroplasty.

Level of Evidence

III


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