SURGICAL TECHNIQUE: Cemented and Hybrid Cemented Stem Use in Revision TKA
One of the keys to a successful revision total knee arthroplasty (TKA) is stable metaphyseal fixation, says Jay R. Lieberman, MD, from Keck School of Medicine at USC in Los Angeles. A short cemented stem is the workhorse for most surgeons, as it:
- Allows for rapid fixation
- Does not burn bone stock for future revisions
- Can be used with cones
- Can be used to deliver local antibiotics
RELATED: Dr. Arlen Hanssen performs a revision TKA for an infected knee
Dr. Lieberman discussed the use of cemented and hybrid cemented/cementless stems for revision procedures at ICJR’s annual Revision Hip & Knee Course, commenting on the surgical technique and pros and cons of cemented and cementless stems, as well as reviewing data on the hybrid technique. [1,2]
Click the link above to watch Dr. Lieberman’s presentation.
Disclosures
Dr. Lieberman has no disclosures relevant to this presentation.
References
- Fleischman AN, Azboy I, Fuery M, Restrepo C, Shao H, Parvizi J. Effect of stem size and fixation method on mechanical failure after revision total knee arthroplasty. J Arthroplasty. 2017 Sep;32(9S):S202-S208.e1. doi: 10.1016/j.arth.2017.04.055. Epub 2017 May 4.
- Heesterbeek PJ, Wymenga A, van Hellemondt GG. No difference in implant micromotion between hybrid fixation and fully cemented revision total knee arthroplasty: a randomized controlled trial with radiostereometric analysis of patients with mild-to-moderate bone loss. J Bone Joint Surg Am 2016 Aug 17;98(16):1359-69. doi: 10.2106/JBJS.15.00909.