High Rates of Aseptic Loosening in Modern Posterior-stabilized Femoral Components From a Single Manufacturer
Background: Total knee arthroplasty (TKA) is one of the most commonly performed surgical procedures in the United States. There are concerns and reports of early aseptic loosening due to debonding at the cement-implant interface in a specific posterior-stabilized femoral design. This study describes...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344123000377 |
| _version_ | 1827860207200370688 |
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| author | Asa Shnaekel, MD, MPH J. Craig Morrison, MD |
| author_facet | Asa Shnaekel, MD, MPH J. Craig Morrison, MD |
| author_sort | Asa Shnaekel, MD, MPH |
| collection | DOAJ |
| description | Background: Total knee arthroplasty (TKA) is one of the most commonly performed surgical procedures in the United States. There are concerns and reports of early aseptic loosening due to debonding at the cement-implant interface in a specific posterior-stabilized femoral design. This study describes failure at the cement-implant interface with 2 femoral implant designs produced by a single manufacturer. Methods: This is a review of failed primary total knee arthroplasties performed with Optetrak Logic and Truliant posterior-stabilized femoral components between 2010 and 2020. Cases with revision surgery performed for femoral component loosening were reviewed. Results: Seventeen of 896 knees were revised for femoral component loosening. The mean time from index arthroplasty to revision was 73 months. Patients presented with knee pain and recurrent aseptic effusions. More than half of patients had no evidence of component loosening on plain radiographs. Bone scans were positive in 77% of patients with loosening. Femoral components were easily disimpacted from the cement mantle at the time of revision surgery. Patients were treated with femoral only revision or femoral and tibial revision. Two complications occurred in this series. Conclusions: Providers should maintain vigilance in the surveillance of patients with these implants. Clinicians should have a low threshold for additional diagnostic testing if these patients develop pain and/or recurrent effusions. Isolated femoral or complete revision both seem to be acceptable treatment strategies for this failure mechanism. |
| first_indexed | 2024-03-12T13:19:57Z |
| format | Article |
| id | doaj.art-f4ee5f31b6744ed293c4609397100b38 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-03-12T13:19:57Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-f4ee5f31b6744ed293c4609397100b382023-08-26T04:43:30ZengElsevierArthroplasty Today2352-34412023-08-0122101132High Rates of Aseptic Loosening in Modern Posterior-stabilized Femoral Components From a Single ManufacturerAsa Shnaekel, MD, MPH0J. Craig Morrison, MD1Corresponding author. Southern Joint Replacement Institute, TriStar Centennial Medical Center, 2400 Patterson Street, Suite 100, Nashville, TN 37203, USA. Tel.: +1 501 337 3770.; Southern Joint Replacement Institute, TriStar Centennial Medical Center, Nashville, TN, USASouthern Joint Replacement Institute, TriStar Centennial Medical Center, Nashville, TN, USABackground: Total knee arthroplasty (TKA) is one of the most commonly performed surgical procedures in the United States. There are concerns and reports of early aseptic loosening due to debonding at the cement-implant interface in a specific posterior-stabilized femoral design. This study describes failure at the cement-implant interface with 2 femoral implant designs produced by a single manufacturer. Methods: This is a review of failed primary total knee arthroplasties performed with Optetrak Logic and Truliant posterior-stabilized femoral components between 2010 and 2020. Cases with revision surgery performed for femoral component loosening were reviewed. Results: Seventeen of 896 knees were revised for femoral component loosening. The mean time from index arthroplasty to revision was 73 months. Patients presented with knee pain and recurrent aseptic effusions. More than half of patients had no evidence of component loosening on plain radiographs. Bone scans were positive in 77% of patients with loosening. Femoral components were easily disimpacted from the cement mantle at the time of revision surgery. Patients were treated with femoral only revision or femoral and tibial revision. Two complications occurred in this series. Conclusions: Providers should maintain vigilance in the surveillance of patients with these implants. Clinicians should have a low threshold for additional diagnostic testing if these patients develop pain and/or recurrent effusions. Isolated femoral or complete revision both seem to be acceptable treatment strategies for this failure mechanism.http://www.sciencedirect.com/science/article/pii/S2352344123000377Revision total knee arthroplastyFemoral aseptic looseningExactechOptetrak logicTruliant |
| spellingShingle | Asa Shnaekel, MD, MPH J. Craig Morrison, MD High Rates of Aseptic Loosening in Modern Posterior-stabilized Femoral Components From a Single Manufacturer Arthroplasty Today Revision total knee arthroplasty Femoral aseptic loosening Exactech Optetrak logic Truliant |
| title | High Rates of Aseptic Loosening in Modern Posterior-stabilized Femoral Components From a Single Manufacturer |
| title_full | High Rates of Aseptic Loosening in Modern Posterior-stabilized Femoral Components From a Single Manufacturer |
| title_fullStr | High Rates of Aseptic Loosening in Modern Posterior-stabilized Femoral Components From a Single Manufacturer |
| title_full_unstemmed | High Rates of Aseptic Loosening in Modern Posterior-stabilized Femoral Components From a Single Manufacturer |
| title_short | High Rates of Aseptic Loosening in Modern Posterior-stabilized Femoral Components From a Single Manufacturer |
| title_sort | high rates of aseptic loosening in modern posterior stabilized femoral components from a single manufacturer |
| topic | Revision total knee arthroplasty Femoral aseptic loosening Exactech Optetrak logic Truliant |
| url | http://www.sciencedirect.com/science/article/pii/S2352344123000377 |
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