Stem pain after cementless revision total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Arthroplasty Research

Background:

• Revision total knee arthroplasty (TKA) frequently necessitates long diaphyseal stems for support.
• Pain associated with cemented revision stems is documented, but incidence in cementless revision TKA remains unstudied.
• Understanding stem pain in cementless revision TKA is crucial for patient outcomes and surgical planning.

Purpose of the Study:

• To investigate the incidence of tibial stem pain in patients undergoing cementless revision total knee arthroplasty (TKA) using diaphyseal slotted stems.
• To compare the incidence of stem pain in cementless revision TKA with a control group of primary TKA patients receiving metaphyseal stems.

Main Methods:

• A retrospective review of 120 cementless revision TKAs with diaphyseal slotted stems.
• A control cohort of 100 primary TKA patients with metaphyseal stems.
• Comparison of reported stem pain incidence between the revision and primary TKA cohorts.

Main Results:

• Twenty of 120 (16.7%) patients in the revision cohort reported pain at the distal end of the tibial stem; no thigh pain was reported.
• Seven of 100 (7%) patients in the primary TKA cohort reported pain below the tibial stem.
• No significant correlation was found between stem length, stem fit, and reported pain.

Conclusions:

• Over 16% of patients may experience pain at the end of a press-fit revision TKA stem.
• Tibial stem pain is a notable complication in cementless revision TKA.
• Informed patient consent regarding potential stem pain is essential prior to revision TKA surgery.