Extent of vertical cementing as a predictive factor for radiolucency in revision total knee arthroplasty View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-02-01

AUTHORS

Du Hyun Ro, Yool Cho, Sahnghoon Lee, Kee Yun Chung, Seong Hwan Kim, Young Min Lee, Joon Kyu Lee, Myung Chul Lee

ABSTRACT

PurposeLimited information is available regarding the effects of cementing extent on implant stability in patients who have undergone revision total knee arthroplasty (TKA). As such, the goals of this study were: (1) to determine the correlation between the extent of vertical cementing and implant loosening; (2) to determine whether the extent of cementing is a potential predictive factor for radiolucency; and (3) to evaluate the minimal amount of cement needed for a stable implant during revision TKA using a hybrid technique.MethodsOne hundred nine stemmed/revision TKAs with a mean follow-up period of 5 years were retrospectively analysed. In each case, a single varus–valgus constrained implant was used and fixed with a hybrid technique. Implant stability was evaluated according to the modified Knee Society radiographic scoring system. The extent of vertical cementing was defined as the longitudinal length from the implant base to the end of the radiopaque line around the stem on radiograph. Its correlation with implant stability was analysed, and the minimal value for a stable implant was evaluated with a receiver operating characteristic (ROC) analysis.ResultsThe mean extent of vertical cementing was longer in stable implants (femur: p = 0.001, tibia: p = 0.004) and significantly correlated with implant stability (femur: p < 0.001, tibia: p = 0.001). A logistic regression analysis revealed that the risk of loosening was 8.7–16.1 times higher when the extent of cementing was <40 mm, which was located at the stem–implant junction of the modular implant. The minimal extent of vertical cementing was estimated to be 60 mm for a stable femoral implant and 50 mm for a tibial implant.ConclusionsThe hybrid fixation technique with a cementing extent >60 mm for the femur and 50 mm for the tibia was durable at a mean follow-up period of 5 years. Vertical cementing 10–20 mm above the stem–implant junction is recommended when performing revision TKA using this technique.Level of evidenceIV. More... »

PAGES

2710-2717

References to SciGraph publications

  • 2012-04-08. Revision total knee arthroplasty with varus–valgus constrained prosthesis versus posterior stabilized prosthesis in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2007-05. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences in BEHAVIOR RESEARCH METHODS
  • 2008-11-26. Results of Press-fit Stems in Revision Knee Arthroplasties in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • 2014-01-12. The Rotaglide mobile-bearing total knee arthroplasty: no difference between cemented and hybrid implantation in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2012-10-04. Trends in Use of Total Knee Arthroplasty in Korea From 2001 to 2010 in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • 2010-09-07. Fixation of revision TKA: a review of the literature in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00167-016-4011-7

    DOI

    http://dx.doi.org/10.1007/s00167-016-4011-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1035291217

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/26831861


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