Abstract
Aim: To present the experience of a highly specialized total knee arthroplasty revision center with the use of femoral and tibial components with modular press-fit offset stem extensions.
Methods: Intramedullary press-fit offset stem extensions were developed to offer an additional option when doing a revision total knee arthroplasty in the presence of periarticular bone loss. The radiological and clinical results of a cohort of 28 patients that had been previously subjected to a revision total knee arthroplasty utilizing modular press-fit offset stem extensions, were studied. Mean follow-up time of these patients was 3.5 years (range, 2–7 years). The NexGen Legacy Knee System was used in all our patients (25% LCCK, 75% LPS). The use of bone cement was restricted to the femoral and tibial articular surfaces only, without any intra-medullary use.
Results: Femoral intramedullary fit and fill was measured 87.9% in anteroposterior x-rays and 85.5% in laterals. Tibial intramedullary fit and fill was measured 94.5% in anteroposterior x-rays and 89.9% in laterals. Femoral components were implanted in 6.4 degrees of valgus angle (mean values) and 2.5 degrees of flexion (mean values). Tibial components were implanted in 2.2 degrees of valgus angle (mean values) and 3 degrees of posterior slope (mean values). Knee Society Score was 89.5 points, while Function Score was 84.8. One year post-revision follow-up evaluation revealed 89% satisfaction rate among these patients.
Conclusion: The use of these press-fit offset stem extensions, with the best possible intramedullary femoral and tibial fit and fill, offer a very rewarding method and an alternative option to deal with complex reconstructive problems during a revision total knee arthroplasty.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
