TY - JOUR
T1 - Revision Total Knee Arthroplasty With a Rotating-Hinge Prosthesis Mated to a Well-Fixed Femoral Sleeve
AU - Hannon, Charles P.
AU - Stuart, Michael B.
AU - Abdel, Matthew P.
AU - Pagnano, Mark W.
AU - Trousdale, Robert T.
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022
Y1 - 2022
N2 - Background: Some knee systems have the unique capability to mate a new hinged femoral component to a well-fixed metaphyseal sleeve from a prior revision. We compared survivorship, radiographs, and clinical outcomes of a rotating-hinge total knee arthroplasty mated to a new metaphyseal sleeve vs a well-fixed sleeve. Methods: Sixty patients with an S-ROM Noiles (DePuy Synthes, Warsaw, IN) rotating-hinge total knee arthroplasty implanted from 1998 to 2019 were retrospectively reviewed. Nine patients (15%) had the femoral component mated to a well-fixed sleeve and 51 patients (85%) had a new sleeve. Mean age was 68 years, 68% were female, and mean body mass index was 33 kg/m2. The incidences of re-revision and reoperation were calculated, Knee Society Scores were measured, and radiographs were reviewed. Mean follow-up was 5 years. Results: There were 2 re-revisions (22%) in patients with a well-fixed sleeve: 1 for infection and 1 for aseptic loosening of the femur and tibia. There were no unique failures including the taper junction. Nine patients (18%) with a new sleeve were re-revised: 7 for infection and 2 for tibial aseptic loosening. The mean Knee Society Score for all patients improved from 39 to 73. Radiographically, all components were well fixed except for one loose femur in a patient with a new sleeve. Conclusion: Mating an S-ROM femur to a well-fixed sleeve from a prior revision is a safe, simple, and durable option in the short term that prevents morbidity associated with removal of a well-fixed sleeve. No new modes of failure were observed. Level of Evidence: IV (retrospective), Therapeutic.
AB - Background: Some knee systems have the unique capability to mate a new hinged femoral component to a well-fixed metaphyseal sleeve from a prior revision. We compared survivorship, radiographs, and clinical outcomes of a rotating-hinge total knee arthroplasty mated to a new metaphyseal sleeve vs a well-fixed sleeve. Methods: Sixty patients with an S-ROM Noiles (DePuy Synthes, Warsaw, IN) rotating-hinge total knee arthroplasty implanted from 1998 to 2019 were retrospectively reviewed. Nine patients (15%) had the femoral component mated to a well-fixed sleeve and 51 patients (85%) had a new sleeve. Mean age was 68 years, 68% were female, and mean body mass index was 33 kg/m2. The incidences of re-revision and reoperation were calculated, Knee Society Scores were measured, and radiographs were reviewed. Mean follow-up was 5 years. Results: There were 2 re-revisions (22%) in patients with a well-fixed sleeve: 1 for infection and 1 for aseptic loosening of the femur and tibia. There were no unique failures including the taper junction. Nine patients (18%) with a new sleeve were re-revised: 7 for infection and 2 for tibial aseptic loosening. The mean Knee Society Score for all patients improved from 39 to 73. Radiographically, all components were well fixed except for one loose femur in a patient with a new sleeve. Conclusion: Mating an S-ROM femur to a well-fixed sleeve from a prior revision is a safe, simple, and durable option in the short term that prevents morbidity associated with removal of a well-fixed sleeve. No new modes of failure were observed. Level of Evidence: IV (retrospective), Therapeutic.
KW - aseptic loosening
KW - bone loss
KW - metaphyseal sleeves
KW - revision
KW - survivorship
KW - total knee arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=85127348823&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2022.02.075
DO - 10.1016/j.arth.2022.02.075
M3 - Article
C2 - 35227812
AN - SCOPUS:85127348823
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
SN - 0883-5403
ER -