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Outcomes of Metaphyseal Cones and Stem Fixation Following Rotating Hinge in Complex Primary and Revision Total Knee Arthroplasty.
Lizcano, Juan D; Goh, Graham S; Kohli, Meera; Deirmengian, Gregory K; Arsoy, Diren; Courtney, Paul M.
Afiliación
  • Lizcano JD; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
  • Goh GS; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
  • Kohli M; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
  • Deirmengian GK; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
  • Arsoy D; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
  • Courtney PM; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
J Arthroplasty ; 39(8S1): S248-S255, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38360286
ABSTRACT

BACKGROUND:

Although hinged prostheses have been used successfully in complex revision total knee arthroplasty (TKA), concerns exist regarding early failure due to aseptic loosening and other mechanical complications. The use of metaphyseal cones and hybrid cement fixation have been studied in unlinked constrained primary or revision TKA, but their impact on the survivorship of hinged prostheses has yet to be investigated.

METHODS:

We identified a consecutive series of 164 hinged prostheses and collected data on demographics, indications, complications, and re-revisions in patients who had fully cemented versus hybrid stems, with and without metaphyseal cones. A multivariate analysis was performed to identify independent variables associated with re-revision as the primary end point.

RESULTS:

In total, 84 patients (51.2%) had fully cemented stems, and 80 patients (48.8%) had hybrid stems. Cones were used in 73 patients (44.5%). At a mean follow-up of 3.4 ± 2.2 years, 42 patients underwent re-revision (25.8%), most commonly for infection (12.2%), followed by loosening (6.7%) and periprosthetic fracture (3.7%). Patients who had fully cemented stems had lower re-revision rates than hybrid fixation constructs (19 versus 26%, P = .043). Using multivariable regression, a construct with hybrid fixation with cones (odds ratio = 2.39; P = .037) was an independent risk factor for failure. Utilization of cones alone did not have an effect on re-revision rates at 3.4-year follow-up.

CONCLUSIONS:

While we found no difference with the use of cones, patients undergoing revision TKA with a hinge prosthesis and fully cemented stems had better overall survivorship than hybrid stems.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diseño de Prótesis / Reoperación / Falla de Prótesis / Artroplastia de Reemplazo de Rodilla / Prótesis de la Rodilla Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diseño de Prótesis / Reoperación / Falla de Prótesis / Artroplastia de Reemplazo de Rodilla / Prótesis de la Rodilla Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos