Francisco A Miralles-Muñoz1, Matias Ruiz-Lozano1, Adolfo Perez-Aznar1, Emilio Sebastia-Forcada1, Alejandro Lizaur-Utrilla2,3, M Flores Vizcaya-Moreno4. 1. Department of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, 03600, Elda, Alicante, Spain. 2. Department of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, 03600, Elda, Alicante, Spain. lizaur1@telefonica.net. 3. Department of Traumatology and Orthopaedics, Faculty of Medicine, Miguel Hernandez University, N-332 km 87 s/n, 03550, San Juan de Alicante, Alicante, Spain. lizaur1@telefonica.net. 4. Unit of Nursing Research, Faculty of Health Sciences, Alicante University, 03690, S. Vicente Raspeig, Alicante, Spain.
Abstract
PURPOSE: The tibial stem fixation in an aseptic revision of total knee arthroplasty is poorly studied and controversial. The objective of this study was to prospectively compare clinical outcomes between hybrid and cemented fixation of the stem in aseptic tibial revision after a minimum follow-up of 5 years. METHODS: Two sequential prospective cohorts of patients who underwent aseptic tibial revision were compared after a minimum follow-up of five years: 31 had both tibial tray and stem cemented (cemented group), and 42 had a hybrid fixation with tibial tray cemented and stem cementless (hybrid group). Clinical assessment was performed by the Knee Society Scores and reduced Western Ontario and McMaster Universities Arthritis Index. Radiological assessment was also performed. RESULTS: There were no significant differences in preoperative data between groups. Postoperatively, no significant differences between groups in clinical scores or complication rate were found. Survival of the TKA revision at 5-year was 94% (95% CI 89-98%) in the cemented group, and 98% (95% CI 92-100%) in the hybrid group (ns). CONCLUSION: Clinical outcomes and implant survival were comparable between hybrid and cemented tibial stem fixation. LEVEL OF EVIDENCE: II.
PURPOSE: The tibial stem fixation in an aseptic revision of total knee arthroplasty is poorly studied and controversial. The objective of this study was to prospectively compare clinical outcomes between hybrid and cemented fixation of the stem in aseptic tibial revision after a minimum follow-up of 5 years. METHODS: Two sequential prospective cohorts of patients who underwent aseptic tibial revision were compared after a minimum follow-up of five years: 31 had both tibial tray and stem cemented (cemented group), and 42 had a hybrid fixation with tibial tray cemented and stem cementless (hybrid group). Clinical assessment was performed by the Knee Society Scores and reduced Western Ontario and McMaster Universities Arthritis Index. Radiological assessment was also performed. RESULTS: There were no significant differences in preoperative data between groups. Postoperatively, no significant differences between groups in clinical scores or complication rate were found. Survival of the TKA revision at 5-year was 94% (95% CI 89-98%) in the cemented group, and 98% (95% CI 92-100%) in the hybrid group (ns). CONCLUSION: Clinical outcomes and implant survival were comparable between hybrid and cemented tibial stem fixation. LEVEL OF EVIDENCE: II.