Stemmed femoral implants show lower failure rates in revision total knee arthroplasty

Stemmed femoral implants are not universally used in revision total knee arthroplasty. The aim of this study was to evaluate whether the re-revision rate would be greater for revision total knees performed without stemmed femoral implants compared with revision total knees performed with stemmed femoral implants.

All revision cases performed at a single institution between 2004 and 2011 were retrospectively reviewed. A total of 130 revision total knee arthroplasty procedures (63 Group 1; 67 Group 2) met the inclusion criteria.

Revisions performed without femoral stems failed more often than revisions with femoral stems (44% vs 9%, p < 0.001) despite more severe pre-operative bone loss in groups that were revised with stems (p < 0.05).

We recommend that femoral stems be used routinely in procedures where a femoral implant is revised following a prior total knee arthroplasty.