Fixation of revision TKA: a review of the literature

Purpose Early aseptic loosening is a major complication in revision total knee arthroplasty (TKA). It is well accepted that intramedullary stems improve the anchoring of the prosthetic components; however, controversy still exists about the optimal fixation technique of the stems (cementless, hybrid...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2011-06, Vol.19 (6), p.872-879
Main Authors: Beckmann, J., Lüring, C., Springorum, R., Köck, F. X., Grifka, J., Tingart, M.
Format: Article
Language:English
Subjects:
Arthroplasty, Replacement, Knee - adverse effects
Arthroplasty, Replacement, Knee - methods
Bone Cements
Female
Follow-Up Studies
Humans
Knee
Knee Prosthesis
Knees
Literature reviews
Male
Medicine
Medicine & Public Health
Orthopedics
Osteoarthritis, Knee - surgery
Pain Measurement
Prosthesis Failure
Prosthetics
Recovery of Function
Reoperation - methods
Risk Assessment
Sports
Surgery
Techniques
Time Factors
Treatment Outcome
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Summary:Purpose Early aseptic loosening is a major complication in revision total knee arthroplasty (TKA). It is well accepted that intramedullary stems improve the anchoring of the prosthetic components; however, controversy still exists about the optimal fixation technique of the stems (cementless, hybrid, cemented). Methods A literature review was carried out in the main medical databases from 1980 to 04/2010 to evaluate the available literature by evidence-based criteria and to analyse the results of the single studies regarding fixation technique in knee revision arthroplasty. Results There are four studies regarding the cementless fixation. Eight studies reported the hybrid technique and five studies the cemented technique. Hybrid and cemented techniques are comparable regarding the survival of arthroplasties, the rate of aseptic loosening and the clinical outcome. However, most studies just show a low level of evidence (LoE III and IV), a small to medium number of cases and a short follow-up. Conclusion Based on the current literature, no final statement can be drawn regarding the optimal fixation technique in revision TKA. Future RCTs are needed to enable conclusive statements about the possible advantages and disadvantages of the single fixation techniques, although the clinical implementation often is critical.
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-010-1249-3