206
· DOS Abstracts
Cementless Metaphyseal Sleeves without Stem in
Revision Total Knee Arthroplasty
David Gøttsche, Thomas Lind, Thorbjørn Christiansen,
Henrik Morville Schrøder
Ortopædkirurgisk, Gentofte
Background:
Revision knee arthroplasty with cementless metaphyseal sleeve is
suggested used without stem in revision total knee arthroplasty (rTKA). In order
to assess the relevant indications, this study is needed. No papers investigating
this have been published.
Purpose / Aim of Study:
We wanted to review the results of this concept in
order to assess clinical outcome and relevant indications.
Materials and Methods:
In this retrospective study we identified 71 patients
operated with revision knee arthroplasty with cementless metaphyseal sleeves
without stem in the period 2009-2011. All patients with the prosthesis still
in place were invited to a medical examination including x-rays. We used the
American Knee Society Score (AKSS) and The Oxford Knee Score (OKS) as the
primary clinical outcomes.
Findings / Results:
We found a significant increase in AKSS; from 62.7 to
109.6; (p-value <0.0000001) and a postoperative OKS of 32.1. We found an
overall satisfaction of 2.5 on a four stage scale, going from very satisfied to
dissatisfied (range 1 - 4). The Anderson Orthopaedic Research Institute (AORI)
classification showed 63 % of the tibias and 56 % of the femurs to be AORI
type 2B, whereas 19 % tibias and 5 % femurs were AORI type 3. The review of
the x-rays showed all prostheses fixed. The mean number of revisions was 1.7
(range 1 - 5). Six patients were not evaluated. One died, one had an above knee
amputation, and four were revised (one infection, one aseptic loosening; one
instability, and one pain without loosening).
Conclusions:
We found that the prostheses were overall well fixed and patients’
AKSS increased significantly. Many patients had comorbid pain conditions, and
realistic expectations are crucial in order to get satisfied patients.
153.
