Are Stems Redundant in Times of Metaphyseal Sleeve Fixation?

Scior, Wolfgang; Chanda, Debashish; Graichen, Heiko

doi:10.1016/j.arth.2019.05.031

Cited by 18 publications

(11 citation statements)

References 27 publications

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“…Centered on the poor functional prognosis, given the substantial proportions of the lesion, an endoprosthetic reconstruction was planned to restore anatomy and functionality. We opted for an oncologic rotating hinge prosthesis with a metaphyseal stemless sleeve for the tibial component based on the surgeon’s preference, the excellent clinical improvement, and the leg alignment restoration that can be achieved with this technique [ 17 ]. Previous literature had described the potential of limb-salvage surgery as a replacement for amputation in patients with primary bone tumors of the distal femur [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Distal Femoral Replacement as a Salvage Treatment After Desmoplastic Fibroma Resection

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Distal Femoral Replacement as a Salvage Treatment After Desmoplastic Fibroma Resection

et al. 2022

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“…Although Thorsell et al described good midterm results of stemless sleeve fixation, they also had an increased risk for malpositioning of the implant [ 32 ]. Scior et al recently reported successful outcomes of a larger series of stemless sleeve constructs [ 37 ]. The authors limited its use to cases in which zone 1 and 2 fixation was sufficient (AORI type 1 and type 2A) together with navigation use in cases with femoral or tibial deformity to prevent malpositioning.…”

Section: Discussionmentioning

confidence: 99%

Cementless Metaphyseal Sleeve Fixation in Revision Knee Arthroplasty: Our Experience with an Arabic Population at the Midterm

Algarni

2020

Advances in Orthopedics

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Objective. Metaphyseal sleeve (MS) fixation in revision knee arthroplasty (RKA) among Western populations has been reported with very encouraging outcomes. The aim of this study was to report our experience with the use of MS in RKA among an Arabic population. Clinical and radiographic outcomes and implant survivorship were reported at a minimum follow-up of 2 years and a mean follow-up of 4.1 years. Methods. A retrospective analysis was conducted on prospectively collected data of patients who underwent RKA with a MS in combination with a cementless stem (femoral or tibial). Range of motion (ROM) and Knee Society Score (KSS) were obtained pre- and postoperatively. Complications, occurrence of stem-tip pain, and implant survival were documented. Knee radiographs were obtained to evaluate the alignment and osseointegration or loosening of the MS. Results. A total of 52 sleeves (27 tibial and 25 femoral) implanted in 27 RKAs (27 patients) were included. The mean follow-up period was 4.1 ± 1.8 (2–7.5) years. Postoperatively, the ROM improved from 89.3 ± 9.2 to 106.3 ± 11.4 (p = 0.19) and the KSS also significantly improved, from 102.9 ± 35.6 to 130.2 ± 33.7 (p < 0.001). One patient (3.7%) developed heterotopic ossification, and another one (3.7 %) had a stem-tip pain on the tibial side; both were managed conservatively. One patient (3.7 %) sustained a fracture and required reoperation. None of the sleeves showed progressive radiolucent lines, and none required revision. The aseptic survivorship and overall survivorship at a mean of 4.1 years were 100% and 96.3%, respectively. Conclusion. MS provided successful midterm outcomes that were maintained in obese patients with different levels of constraint. Our series supports their use as a viable option in RKA.

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“…Another specific feature of our study is that all patients included in the study had severe metaphyseal bone defects of the AORI classification grade III [ 9 , 21 ]. This distinguishes this patient population from other studies that included patients of all AORI grades in their study.…”

Section: Discussionmentioning

confidence: 99%

Metaphyseal sleeves in arthroplasty of the knee

et al. 2020

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Background This study examined the clinical outcome following revision arthroplasty of the knee joint and severe arthrosis with metaphyseal bone defects and instability using metaphyseal sleeves. We analyzed the results based on established scores and recorded the complications occurring on revision arthroplasty. Material and methods Patients with revision arthroplasty of the knee and metaphyseal bone defects grade III according to the Anderson Orthopedic Research Institute (AORI) classification were included (16 patients, 9 females and 7 males). In all cases, surgery was performed using an endoprosthesis COMPLETE™ revision knee system with metaphyseal sleeves. Results All patients had a significant reduction in pain level after revision surgery. The median HSS score in the cohort with primary arthroplasty was 84 and in the cohort with revision arthroplasty 73 and the KSS was 83 and 55, respectively. According to the HSS an excellent result was achieved by 50% of the patients in the primary arthroplasty group and 25% in the revision group. Only three patients were considered to have an insufficient result. Postoperative pain was significantly reduced in both groups. The median ROM was 112° flexion in the primary arthroplasty group and 95° in the revision group. An extension deficit was observed in three patients and four patients showed prolonged wound healing postoperatively (25%), which was treated conservatively and did not lead to septic changes. Conclusion The use of metaphyseal sleeves in patients with bone defects is a suitable instrument with no negative impact on the outcome both in primary and revision arthroplasty. Further studies with larger study groups and analysis of long-term results after use of such endoprosthetic components should be conducted.

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Are Stems Redundant in Times of Metaphyseal Sleeve Fixation?

Cited by 18 publications

References 27 publications

Distal Femoral Replacement as a Salvage Treatment After Desmoplastic Fibroma Resection

Distal Femoral Replacement as a Salvage Treatment After Desmoplastic Fibroma Resection

Cementless Metaphyseal Sleeve Fixation in Revision Knee Arthroplasty: Our Experience with an Arabic Population at the Midterm

Metaphyseal sleeves in arthroplasty of the knee

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