The use of metaphyseal sleeves in revision total knee arthroplasty has gained popularity with numerous clinical series demonstrating excellent osseointegration and survivorship at medium- to long-term follow up. Once osseointegrated, sleeves provide excellent biological fixation and are difficult to remove. Here, we describe our surgical technique and sequence in removing metaphyseal sleeves in contemporary revision knee systems with case demonstrations.
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http://dx.doi.org/10.1615/JLongTermEffMedImplants.2022041715 | DOI Listing |
SICOT J
January 2025
Department of Orthopedic Surgery and Sport Medicine, Croix-Rousse Hospital, FIFA Medical Center of Excellence, 69004 Lyon, France - Université de Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406, 69622 Lyon, France.
Introduction: Revision Total Knee Arthroplasty (RTKA) is complex, and induced bone loss might endanger implant fixation and joint stability. Intramedullary stems improve fixation throughout stress redistribution. The current study aims to compare the performance of short tibial stems with long tibial stems, investigating their intermediate-term radiographic and survival outcomes in RTKA.
View Article and Find Full Text PDFJBJS Essent Surg Tech
December 2024
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
Background: For complete disruption of the posterolateral corner (PLC) structures, operative treatment is most commonly advocated, as nonoperative treatment has higher rates of persistent lateral laxity and posttraumatic arthritis. Some studies have shown that acute direct repair results in revision rates upwards of 37% to 40% compared with 6% to 9% for initial reconstruction. In a recent study assessing the outcomes of acute repair of PLC avulsion injuries with 2 to 7 years of follow-up, patients with adequate tissue were shown to have a much lower failure rate than previously documented.
View Article and Find Full Text PDFCureus
September 2024
Orthopaedics, KIMS-Sunshine Hospitals, Hyderabad, IND.
Introduction Revision Total Knee Arthroplasty (RTKA) is a complex procedure challenged by significant bone loss, necessitating effective restoration techniques. This study investigates the clinical outcomes and complications of metaphyseal sleeves in RTKA with severe metaphyseal bone loss, aiming to evaluate their efficacy over a minimum four-year follow-up. Methods This was a retrospective observational study on 29 patients who underwent RTKA with Anderson Orthopaedic Research Institute (AORI) type II or III bone defects using porous coated tibial and/or femoral metaphyseal sleeves from December 2016 and January 2019.
View Article and Find Full Text PDFCase Rep Orthop
July 2024
Department of Orthopaedic Surgery Shiga University of Medical Science, Seta, Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.
Knee osteoarthritis (OA) with extra-articular deformity (EAD) is a rare condition for which achieving accurate alignment with total knee arthroplasty (TKA) is difficult. Extra-articular corrective osteotomy may be necessary for severe deformities. A 76-year-old man underwent TKA for knee OA with EAD due to malunion after fractures of the femur and tibia.
View Article and Find Full Text PDFSemin Musculoskelet Radiol
August 2024
Section of Musculoskeletal Imaging, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
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