ArticleBMC musculoskeletal disorders2025
Metaphyseal sleeve and straight stem fixation with or without screws for bone defect in complex primary total knee arthroplasty in Eastern Asian populations.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Complex primary total knee arthroplasty with constrained condylar knee in post-traumatic arthritis: a retrospective comparison between 3D-printed patient-specific instrumentation and conventional instrumentation.Journal of orthopaedic surgery and research · 2025Article
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5 authors.
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Abstract
backgroundMassive bone defects present significant challenges in complex primary total knee arthroplasty (TKA). Previous studies with limited sample sizes have demonstrated the potential of metaphyseal sleeves (MS) in addressing such defects. This study mainly aimed to assess the clinical outcomes and survivorship of MS utilized for reconstructing bone defects in complex primary TKA among East Asian patients, with a secondary focus on the use of scews for tibial residual bone defect.
methodsA total of 3,672 primary TKAs were performed between January 2016 and December 2020, of which 106 procedures (87 patients) utilized MS in conjunction with straight stems to address bone defects. Among these, 55 (46 patients) incorporated screws for tibial residual bone defect, while 51 (41 patients) were performed without screws. The mean follow-up period was 57.86 months, during which demographic data, operative details, clinical and radiographic outcomes, complications, and implant survivorship were recorded and analyzed.
resultsAll cases demonstrated successful osteointegration, with both the endpoint reoperation and revision implant survival rates reaching 100%. The mean Hospital for Special Surgery (HSS) score significantly improved from 56.98 to 82.36 at the final follow-up, resulting in an overall excellent and good outcome rate of 95.40%. Knee conditions were notably worse in the screw group compared to the non-screw group; however, the clinical and radiographic outcomes between the two groups were comparable. Postoperative tibial end-of-stem pain was reported in 9.8% of the non-screw group, while none (0%) in the screw group, reflecting marginal significance (P = 0.0548).
conclusionThe application of metaphyseal sleeves with straight stems represents a promising strategy for addressing massive bone defects in complex primary TKA among East Asian patients. The cement-screw technique, providing potential biomechanical advantages, emerges as a safe and effective solution for managing residual defects surrounding MS placement in tibial site.
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