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Noncemented revision total knee arthroplasty

C S Mow1, J D Wiedel

  • 1Department of Orthopaedics, University of Colorado Health Sciences Center, Denver, CO.

Clinical Orthopaedics and Related Research
|December 1, 1994
PubMed
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Revision total knee arthroplasty using noncemented porous-coated components can achieve successful outcomes. These revision knee replacement procedures demonstrate results comparable to cemented revisions, improving patient function.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering
  • Reconstructive Surgery

Background:

  • Revision total knee arthroplasty (TKA) is complex, with outcomes often depending on fixation methods.
  • Cemented components have been standard, but concerns about long-term fixation and subsidence exist.
  • Nonecemented porous-coated implants offer an alternative fixation strategy for revision TKA.

Purpose of the Study:

  • To evaluate the clinical and radiographic outcomes of revision TKA using noncemented porous-coated components.
  • To compare the efficacy of noncemented porous-coated implants against historical data for cemented revisions.

Main Methods:

  • A retrospective review of 17 revision TKAs performed between 1985 and 1991 on 16 patients.
  • Utilized porous-coated tibial and/or femoral components without cement fixation.

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  • Clinical assessment included the Hospital for Special Surgery (HSS) Knee Rating Scale, radiographs, and range of motion (ROM) evaluation.

    • Main Results:

    • Fifteen revision TKAs were followed for an average of 5.6 years. Average patient age was 65.
    • Significant improvements in ROM (4°-96° to 0°-102°) and HSS scores (52 to 87) were observed.
    • Radiographic evaluation revealed lucent lines in 2 tibial and 1 femoral component, with 2 tibial revisions required for fracture and loosening/breakage. No deep infections occurred.

    Conclusions:

    • Nonecemented porous-coated components can provide successful fixation and functional improvement in revision TKA.
    • Outcomes appear comparable to those reported for cemented revision TKA, suggesting a viable alternative.
    • Further research into long-term survivorship and specific indications for noncemented revision TKA is warranted.