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VIERNES / FRIDAY
296
Inc, Warsaw, IN) was used in 395 patients
(421 TKA) including 271 revision (65%),
reimplantation in 90 (21%), conversion in 11
(3%), complex primary in 47 (11%), and total
femur replacement in 2 (0.5%). Indications
for revision were aseptic loosening in 169
(62%), instability in 45 (17%), arthrofi brosis
in 20 (7%), pain in 13 (5%), periprosthetic
fracture in 11 (4%), malalignment in 6, crepitus
in 3, extensor mechanism dysfunction in
3, and component breakage in 1. Etiology
for complex primary was osteoarthritis in 26
(55%), rheumatoid in 13 (28%), and posttraumatic
in 8 (17%). Follow-up in living patients
averaged 5 years. Knee Society clinical score
improved from 48 to 79, range of motion
improved from 91 degrees to 101 degrees.
Overall survivorship, is 89%. Survivorship
with aseptic revision as the endpoint is 94%.
Revision for sepsis was required in 23 knees
(5%). Of these infections, 9 were recurrent in
the series of 90 reimplantation cases (10%)
and 14 occurred in the 331 knees without
history of infection (4%). Indications for constraint
are reviewed.
THE ROLE OF STEMS
IN REVISION TKA
C. H. Rorabeck, MD
Health Sciences Centre
London - Ontario, Canada
Background:
It is safe to use hybrid fi xation (cementless
stems/cemented articular components) when
performing revision TKA with a varus/valgus
constrained device.
Methods:
110 revision total knee replacements were
performed in 107 patients in a single centre
prospective study using revision intramedullary
stems and a highly constrained polyethylene
insert between 1193 and 1999. All
patients received cemented metaphyseal
components and either a cemented or uncemented
revision intramedullary stem. Seventy
of these patients received uncemented
stems in both the femur and the tibia and
were considered as having “hybrid fi xation”
and were the focus of our study. All 70 of
these patients had complete clinical and
radiographic evaluation.
Results:
There were 9 (12.9%) re-revisions: 3 (4.3%
for aseptic loosening, 2 (2.9%) for recurrent
infection and 4 (5.7%) for instability. The 61
remaining patients were followed for a mean
of 5.1 years (range 2 to 10 years). There was
a 4.3% rate of aseptic loosening and Kaplan-
Meier survivorship of 86.9% at 6.3 years for
all revisions. Signifi cant improvements in
pain scores (18 to 42, p