Problems With Cementless Total Knee Arthroplasty at 11 Years Followup

Berger, Richard A.; Lyon, John H.; Jacobs, Joshua J.; Barden, Regina M.; Berkson, Eric M.; Sheinkop, Mitchell B.; Rosenberg, Aaron G.; Galante, Jorge O.

doi:10.1097/00003086-200111000-00024

Cited by 170 publications

(113 citation statements)

References 21 publications

Supporting

Mentioning

105

Contrasting

Unclassified

Order By: Relevance

“…Failure of the metal-backed patellar component in TKA has been well documented throughout the literature [1,3,4,7,22,23,25,26,31,32,35,36]. This high rate of failure has subsequently led to the markedly decreased use of these components [12,16,31,36].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the metal backing provided a porous coating for cementless fixation. Shortly after the introduction of the metal-backed patellar component into clinical use, early and frequent failures of a variety of dome-shaped metal-backed patellar components became apparent [1,3,4,7,22,23,25,26,31,32,35,36]. In contrast to these reports of metal-backed patellar failures, other authors have reported long-term successful outcomes with metal-backed patellar components of a mobile-bearing design [19].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Isolated All-polyethylene Patellar Revisions for Metal-backed Patellar Failure

Garcia

Kraay

Goldberg

2008

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

The outcome of isolated patellar component revisions after metal-backed patellar failure is variable with satisfactory results reported from 78% to 100%. To supplement information in the literature we determined the failure rate and the functional outcome based on the Knee Society clinical and roentgenographic evaluation systems of isolated patellar component revisions after metal-backed patellar component failure. We retrospectively reviewed 27 patients with 28 isolated patellar component revisions for metal-backed patellar component failure performed between 1988 and 2005. Twenty-five knees in 24 patients were available for review with a minimum followup of 24 months (mean, 90 months; range, 24-210 months).

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Isolated All-polyethylene Patellar Revisions for Metal-backed Patellar Failure

Garcia

Kraay

Goldberg

2008

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Although a well-fixed and stable metal-backed patellar component can be retained, we recommend revising all metal-backed patellar components to a cemented all-polyethylene patellar component because of the high incidence of catastrophic failures associated with metal-backed implants of many designs [1,5,7,25,28,39]. Rorabeck et al [38] similarly suggested surgeons should consider the revision of all metal-backed patellar components regardless of patellar component fixation, damage, or positioning.…”

Section: Retaining the Existing Patellar Componentmentioning

confidence: 99%

Management of the Deficient Patella in Revision Total Knee Arthroplasty

Garcia

Kraay

Conroy-Smith

et al. 2008

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

There are a number of options available to manage the patella when revising a failed total knee arthroplasty. If the previous patellar component is wellfixed, undamaged, not worn, and compatible with the femoral revision component, then it can be retained. When a patellar component necessitates revision and is removed with adequate remaining patellar bone stock, an onlay-type all-polyethylene cemented implant can be used. Management of the patella with severe bony deficiency remains controversial. Treatment options for the severely deficient patella include the use of a cemented all-polyethylene biconvex patellar prosthesis, patellar bone grafting and augmentation, patellar resection arthroplasty (patelloplasty), performing a gull-wing osteotomy, patellectomy, or the use of newer technology such as a tantalum (trabecular metal) patellar prosthesis. Severe patellar bone deficiency is a challenging situation because restoration of the extensor mechanism, proper patellar tracking, and satisfactory anatomic relationships with the femoral and tibial components are critical for an optimal clinical outcome.

show abstract

“…To date, the majority of TKAs in the United States are implanted using cemented tibial components [9,19,23]. However, there have also been some studies that have assessed the use of cementless tibial fixation [3,[10][11][12]18]. Many of these cementless implant designs use additional devices, such as screws, pegs or keels, on the tibial component to improve fixation, and some designs allow for cementation of the tibial tray only while press-fitting the stem or keel of the tibial component.…”

Section: Introductionmentioning

confidence: 99%

Total knee arthroplasty using cementless keels and cemented tibial trays: 10-year results

Kolisek

Mont

Seyler

et al. 2008

International Orthopaedics (SICO

View full text Add to dashboard Cite

The problem of early mechanical stability of cemented and cementless keels of the tibial component in total knee arthroplasty (TKA) is controversial. The purpose of this study was to assess clinical and radiographic outcomes of a cohort of 51 TKAs using a cemented platform with cementless keel fixation. At a mean followup of 10.4 years (range, 7 to 14 years), the mean Knee Society Score (KSS) was 93 points (range, 59 to 100 points), and the mean functional score was 73 points (range, 0 to 100 points). Only one patient demonstrated progressive tibial radiolucencies at 13.1 years follow-up, which resolved with a revision with an exchange of components. The results of this study suggest that a proximally cemented tibial tray with a press-fit keel TKA provides excellent mean 10-year outcomes.

show abstract

Problems With Cementless Total Knee Arthroplasty at 11 Years Followup

Cited by 170 publications

References 21 publications

Isolated All-polyethylene Patellar Revisions for Metal-backed Patellar Failure

Isolated All-polyethylene Patellar Revisions for Metal-backed Patellar Failure

Management of the Deficient Patella in Revision Total Knee Arthroplasty

Total knee arthroplasty using cementless keels and cemented tibial trays: 10-year results

Contact Info

Product

Resources

About