Press-fit fixation of modular diaphyseal stems and metaphyseal sleeves in revision TKA

Forty-two of 50 consecutive revision hinge knees were available for roentgenographic evaluation using the Knee Society System at an average of 58 months (range 32–84 months) postoperative. Condylar segments were cemented and diaphyseal engaging intramedullary femoral and tibial stems and metaphyseal sleeves were press-fit. Radiographs demonstrated bone apposition to all the diaphyseal stems and all the metaphyseal sleeves, except in one instance with a cemented tibial sleeve, which showed minor lucencies at the bone-cement interface. All condylar segments were stable with no progressive radiolucencies. No end stem pain was encountered. The hypothesis that the unique slotted and splined design for press-fit fixation of stems would demonstrate improvement over the high failure rates of solid intramedullary stems was confirmed. The diaphyseal engaging stems combined with metaphyseal sleeves and a third generation mobile-bearing hinge demonstrated excellent results and no mechanical failures at an average 58 month follow-up.