ArticleArchives of orthopaedic and trauma surgery2018
Cemented conical stems can be removed more easily than cylindrical stems, regardless of cone angle in revision knee arthroplasty.
Article in Archives of orthopaedic and trauma surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed, 5 citations in OpenAlex.
- Aseptic midterm survival rates between different cemented tibial stem designs in hinged total knee arthroplasty: a 6-year evaluation from the German Arthroplasty Registry.Archives of orthopaedic and trauma surgery · 2024Article
- Does stem profile have an impact on the failure patterns in revision total knee arthroplasty?Archives of orthopaedic and trauma surgery · 2023Article
- Impact of stem profile on the revisability and the need for osteotomy in well-fixed cemented revision total knee arthroplasty implants.Archives of orthopaedic and trauma surgery · 2023Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccording to literature, more than 30% of revised knee arthroplasties will require at least one re-revision. Practical experience has shown that there are considerable product-specific differences in the explantability of cemented long-stem prostheses. In the registers of successful implants, stem geometry varies considerably between the manufacturers. However, comparative data on explantability of the respective stems are missing. Objective of the present study was to identify a correlation between the geometry of a smooth cemented long stem and the necessary explantation energy required until failure of the implant-cement interface occurs.
methodsEight cemented stems with different conical profile angles (0°-3°) were explanted in a reproducible biomechanical setup each six times to evaluate the correlation between the stem design and the required explantation energy.
resultsThe average explantation energy was highest in the case of the cylindrical stem, at 18.1 ± 3.6 J. At a cone angle of 0.25°, it was just 12.1 ± 2.1 J (p < 0.001) and dropped beyond 0.5° to an average of 5.7 ± 1.8 J (p < 0.001). Between 0.5° and 3°, no significant difference in the required extraction energy was observed.
conclusionsWhereas smooth conical stems can mostly be removed easily, an early decision in favour of osteotomy or fenestration can be taken in the case of cylindrical cemented stems.
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