Revision implants with long stem extensions are routinely implanted in revision TKAs, but they involve more bone loss. The present study was designed to evaluate the possibility of implanting routinely primary implants instead of revision implants during revision TKAs.
The hypothesis of this study will be that the survival rate of primary TKAs implanted for revision cases will not be negatively impacted in comparison to revision implants.

Material And Methods

All patients undergoing a TKA exchange for any reason between January 2013 and December 2017 were included. All patients were operated on by two senior surgeons experienced with revision TKA. The target for reimplantation was: neutral mechanical alignment, orthogonal position of both implants in anteroposterior and lateral planes, restoration of the joint line within 2 mm of the native one, medial and lateral gaps in flexion and in extension less than 5 mm. All these parameters were controlled by a navigation system. Bone loss was filled by bone allografting and/or metal augments without increasing bone defects by additional resection. The smallest implant was chosen, which allowed primary fixation of both implants and graft/augment.
Information about follow-up was collected from the individual patient files. All patients were recalled for clinical and radiological examination. The survival curve was plotted.

Results

158 patients were included: 96 women and 62 men, with a mean age at surgery of 71 ± 10 years. The mean body mass index was 31.6 ± 6.72 kg/m². Reasons for revision were infection (65%), aseptic loosening (13%), implant malposition (10%), and instability (6%).
11 cases were reimplanted with a smaller implant than the implant removed (Group A). 37 cases were reimplanted with the same size of implant than the implant removed (Group B). 31 cases were reimplanted with a longer implant than the implant removed for only one tibial or femoral component (Group C), and 79 cases were reimplanted with a longer implant than the implant removed for both components (Group D). There was no significant difference between all groups for demographic data: age, gender, body mass index, ASA score. Bone defects were significantly larger in group D than in all other groups.
The survival rate of the group A was 100% at 5 years. The survival rate of the group B was 96% at 5 years. The survival rate of the group C was 94% at 5 years. The survival rate of the group D was 92% at 5 years. The differences were not statistically significant.

Discussion

Reimplantation of a TKA smaller or with the same size than the removed implant was possible in 30% of the cases, without a negative impact on the survival rate after 5 years. Both tibial and femoral extension stems were necessary only in 48% of the cases. Navigation offers the possibility to decrease significantly the size of the implants during TKA revision. This might allow preserving bone stock for a possible repeat revision, especially in cases of infected TKA where the failure rate is significantly higher.

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Progenitor Cells with High Chondrogenic Potential are Present in the Adult Human Meniscus ePoster Presentation Jasmijn Korpershoek, MD, NETHERLANDS Margot Rikkers, MSc, NETHERLANDS Tommy de Windt, PhD, NETHERLANDS Marianna Tryfonidou, Prof., NETHERLANDS Daniel Saris, MD, PhD, Prof., UNITED STATES Lucienne A Vonk, PhD, NETHERLANDS
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Surgical Timing Does Not Interfere On Clinical Outcomes In Combined Reconstruction Of The Anterior Cruciate Ligament And Anterolateral Ligament: A Comparative Study With Minimum 2-Year Follow-Up ePoster Presentation Camilo P. Helito, MD, PhD, Prof, BRAZIL Marcel F. Sobrado, MD, PHD, BRAZIL Pedro N. Giglio, MD, BRAZIL Marcelo B. Bonadio, MD, BRAZIL Riccardo Gomes Gobbi, MD, PhD, BRAZIL José R. Pécora, Prof., BRAZIL Gilberto L. Camanho, MD, BRAZIL
Injuries To The Anterolateral Ligament Are Observed More Frequently Compared To Lesions To The Deep Iliotibial Tract (Kaplan Fibers) In Anterior Cruciate Ligamant Deficient Knees Using Magnet Resonance Imaging (Mri) ePoster Presentation Armin Runer, PD MD, GERMANY Dietmar Dammerer, Prof. Dr.med.univ., MSc, PhD, AUSTRIA Johannes M. Giesinger, PhD, NETHERLANDS Michael T. Hirschmann, MD, Prof., SWITZERLAND Michael C. Liebensteiner, MD, PhD, AUSTRIA
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Securing Transplanted Meniscal Allografts Using Bone Plugs Results In Lower Risks Of Graft Failure ePoster Presentation Zachariah Gene Wing Ow, MBBS (Candidate), SINGAPORE Chin Kai Cheong, MBBS (Candidate), SINGAPORE Hao Han Hai, MBBS (Candidate), SINGAPORE Cheng Han Ng, MBBS (Candidate), SINGAPORE Dean Wang, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES Daniel Saris, MD, PhD, Prof., UNITED STATES Keng Lin Francis Wong, MMed(Orth), MCI (NUS), FRCSEd (Orth), FAMS, PhD, SINGAPORE Heng An Lin, MBBS, FRCSEd(Orth), SINGAPORE
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Avoiding Stem Extension During Revision Total Knee Arthroplasty

Avoiding Stem Extension During Revision Total Knee Arthroplasty

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Avoiding Stem Extension During Revision Total Knee Arthroplasty

Avoiding Stem Extension During Revision Total Knee Arthroplasty

Introduction

Material And Methods

Results

Discussion