Good clinical and radiographic outcome of cementless metal metaphyseal sleeves in total knee arthroplasty

Figures & data

Figure 1. Pre- and postperative radiographs of a 56-year-old man who underwent a 2-stage revision for deep periprosthetic infection for which femoral and tibial metaphyseal sleeves were used at the time of reimplantation.

Table 1. Patient characteristics at index surgery (n = 31)

Male/female	11/20
Age, mean (range)	69 (54–89)
BMI, mean (range)	28 (19–41)
Diagnosis:
Primary osteoarthritis	16
Inflammatory arthritis	10
Posttraumatic osteoarthritis	4
Instability	1
Type of surgery (primary/revision)	9/22
Indication for revision (n = 22):
Infection	8
Aseptic loosening	7
Instability	6
Periprosthetic fracture	1
Prosthesis type at index surgery:
S-ROM/TC3	21/10
Tibial component:
Sleeve (yes/no)	28/3
Stem length, mean (range), mm	97 (75–150)
Stem width, mean (range), mm	13 (11–17)
Femoral component:
Sleeve (yes/no)	20/11
Stem length, mean (range), mm	105 (75–175)
Stem width, mean (range), mm	16 (11–20)
Patellofemoral resurfacing (yes/no)	1/30
Type of bone defects:
Tibia (I/II/III)	9/5/17
Femur (I/II/III)	12/3/16

Table 2. Patient characteristics at follow-up (n = 31)

Pain, VAS mm, mean (SD):
Rest	13 (25)
Movement	30 (31)
BMI, mean (range)	27 (19–41)
Range of motion, degrees mean:
Flexion	110 (90–140)
Extension	–3 (–90–0)
Medial-lateral stability:
Stable	28
Unstable	2
Missing	1
Patella:
Tracking	24
Subluxation	4
Dislocation	2
Missing	1
KOOS (SD):
Pain	61 (27)
Other symptoms	65 (23)
Function in daily living	47 (26)
Function in sports and recreation	10 (13)
Knee-related quality of life	44 (35)
EQ-5D (SD)	0.5 (0.4)
Walking aids, clinical improvement	9
Walking distance, clinical improvement	8

Table 3. Radiolucent lines at follow-up

	Radiolucent lines
	n	1 mm	2 mm	> 3 mm
Tibial component:
Anterior-posterior view
Medial plateau (n = 31)	23	7	1	–
Lateral plateau (n = 31)	22	7	2	–
Medial sleeve (n = 28)	24	4	–	–
Lateral sleeve (n = 28)	24	4	–	–
Medial stem (n = 28)	25	3	–	–
Lateral stem (n = 28)	26	2	–	–
Lateral view
Anterior plateau (n = 31)^a	23	6	1	–
Posterior plateau (n = 31)	23	5	2	1
Anterior sleeve (n = 28)^a	24	3	–	–
Posterior sleeve (n = 28)	25	3	–	–
Femoral component:
Anterior-posterior view
Medial stem (n = 28)	23	2	3	–
Lateral stem (n = 28)	22	2	2	2
Lateral view
Shield (n = 31)	23	5	2	1
Anterior sleeve (n = 20)	19	1	–	–
Posterior sleeve (n = 20)	18	2	–	–
Anterior stem (n = 28)	21	3	2	2
Posterior stem (n = 28)	19	5	2	2

a 1 case not gradable.