Table 5.
Overview of the literature: outcomes of stemmed RTKA implants in primary TKA
| Research group | Year | Cases (N) | Stem fixation | Implant type | Stem design | FU (years) | Survival | Asept. Loosening (AL) | PJI | Others |
|---|---|---|---|---|---|---|---|---|---|---|
| Engelbrecht et al. | 1981 | 1074 TKA | Cemented | ENDO Model (LINK) | Co | > 10 | N/A | 6% | 2% | N/A |
| Rand et al. | 1987 | 38 (15 TKA, 23 RTKA) | Cemented | Kinematic RH (Howmedica) | Co | 4–5 | 10y-survival 60% | 13% (RLL 25% f, 50% t) | 16% | N/A |
| Shaw et al. | 1989 | 38 (20 TKA, 18 RTKA) | Cemented | Kinematic RH (Howmedica) | Co | 4 | N/A |
7% TKA, 20% RTKA (RLL 45% TKA, 52% RTKA) |
5% (TKA), 11% (RTKA) | N/A |
| Blauth and Hassenpflug | 1990 | 497 TKA | Cemented | Blauth (Aesculap) | Co | 4 | 10y-survival 89% | 1.2% | 3% | N/A |
| Böhm and Holy | 1998 | 422 TKA | Cemented | Blauth (Aesculap) | Co | 20 | Survival 93.6% | 0.7% | 3.8% | N/A |
| Argenson and Aubaniac | 2000 | 194 TKA | Cemented | ENDO Model (LINK) | Co | 6–7 | Survival > 90% | N/A | 2.5% | 6% Compli |
| Zinck & Sellckau | 2000 | 2682 TKA | Cemented | ENDO Model (LINK) | Co | 5–6 | Survival > 95% | 1% | 1.6% | 11.4% Compli |
| Springer et al. | 2001 | 69 (12 TKA, 57 RTKA) | Cemented | Kinematic RH (Howmedica) | Co | 6 | N/A | N/A | N/A | 32% Compli |
| Himanen et al. | 2002 | 25 (4 TKA, 21 RTKA) | Cemented | AGC DA monobloc (Biomet UK) | Co | 2.3 | N/A | 0% | 4% | 20% Compli |
| Petrou et al. | 2004 | 100 TKA | Cemented | ENDO Model (LINK) | Co | 11 | 15y-survival 96.1% | 0% | 2% | N/A |
| Steckel et al. | 2005 | 227 TKA | Cemented | Blauth (Aesculap) | Co | 10 | 10y-survival 90% | 1.3% (only t) | 3.5% | N/A |
| Pour et al. | 2007 | 44 (17 TKA, 27 RTKA) |
93% Cemented 7% Cementless |
70.5% Kinematic RH (Howmedica) 29.5% Finn RH (Biomed) |
Co Cy(f) Cy-Co(t) |
4.2 | 1y-, 5y-survival 79.6%, 68.2% | 9.1% | 6.8% | N/A |
| Deehan et al. | 2008 | 72 (15 TKA, 57 RTKA) | Cemented | Kinematic RH (Howmedica) | Co | 10 | 5y-survival 90% | 1.4% | 5.6% | N/A |
| Bae et al. | 2009 |
11 TKA Charcot knees |
Cemented | ENDO Model (LINK) | Co | 12.3 | 10y-survival 72.7% | 0% | 9.1% | 27.3% Compli |
| Guenoun et al. | 2009 | 85 (52 TKA, 33 RTKA) | Cemented | ENDO Model (LINK) | Co | 3 | 3y-survival 89.4% | 3.5% | 10.6% | 28.2% Compli |
| Efe et al. | 2012 | 49 (21 TKA, 28 RTKA) | Cemented | ENDO Model (LINK) | Co | 4.7 | Survival 95% TKA, 76% RTKA | 0% (TKA), 7.1% (RTKA) | 4.8% (TKA), 32% (RTKA) | Failure: 14.3% (TKA), 53.6% (RTKA) |
| Yang et al. | 2012 | 50 TKA | Cemented | ENDO Model (LINK) | Co | 15 | 10y-survival 87% | 0% (RLL 10%) | 14% | 14% failure |
| Bistolfi et al. | 2013 | 72 TKA | Cemented | ENDO Model RH (LINK) | Co | 14.5 | 1y-, 5y-, 10y-, 15y-survival 88.7%, 86%, 79.8%, 75.8% | 4.1% | 8.3% | 25% failure |
| Gehrke et al. | 2014 | 141 TKA | Cemented | ENDO Model (LINK) | Co | 13.5 | Survival 90% | 0.5% (f) | 2% | 8% failure |
| Hernandez-Vaquero et al. | 2010 | 26 (5 TKA, 21 RTKA) | Cemented (100% t, 54% f) | Modular RH Prosthesis (Stryker) | Cy-Co | 3.8 | N/A | 0% (RLL 19%) | 7.7% | 11.5% ReOP |
| Kowalczewski et al. | 2014 | 12 TKA | Cementless | Modular RH Prosthesis (Stryker) | Cy-Co | 10–12 | 10y-survival 100% | 0% (RLL 25% t) | 0% | 0% failures |
| Westrich et al. | 2000 | 24 (9 TKA, 15 RTKA) | Cemented | Finn RH (Biomet) |
Cy(f) Cy-Co(t) |
2–3 | survival 100% | 0% | N/A | N/A |
| Barrack et al. | 2001 | 23 (2 TKA, 21 RTKA) | Cementless | S-ROM Noiles (DePuy) | Cy | 4.8 | N/A | 0% | N/A | N/A |
| Kowalczewski et al. | 2004 | 28 (15 TKA, 13 RTKA) | N/A | AGC DA (Biomet UK) | Cy | 0.5 | N/A | 1% | 0% | 2 Compli |
| Springer et al. | 2004 | 26 (4 TKA, 22 RKTA) | Cemented | Modular Segmental Kinematic RH (Howmedica) | Cy | 5 | 10y-survival < 70% | 15.4% (RLL 42.3%) | 19.2% | 31% Compli, 27% ReOP |
| Brinsuk | 2009 | 155 (142 TKA, 13 RTKA) | Cemented | RT-PLUS Solution (Smith&Nephew) | Cy (Co)* | 2 | 0.6% | 4% | 13.5% Compli | |
| Maynard et al. | 2014 | 127 TKA | Cementless | NexGen LCCK (Zimmer) | Cy | 9.2 | 10y-survival 97.6% | 0% | 1.6% | 19.7% Compli, 10.2% RTKA |
| Cholewinski et al. | 2015 | 43 TKA | Cementless | NexGen LCCK (Zimmer) | Cy | 12.7 | 11y-survival 88.5%, aseptic 97.7% | 0% | 4.7% | 16% Compli, 7% RTKA |
| Lique et al. | 2015 | 89 TKA | Cementless | Optetrak CCK (Exactech) | Cy | 9 | 2y-, 8y-survival 93.8%, 90.1% | 2.2% | 6.7% | 7.8% failure |
| Feng et al. | 2016 | 48 TKA | Cementless | NexGen LCCK (Zimmer) | Cy | 6 | 6y-survival 97.9% | 2.1% t, (RLL 8.3%) | 0% | N/A |
| Ye et al. | 2016 | 47 (31 TKA, 16 RTKA) | Cementless | NexGen LCCK (Zimmer) | Cy | 5.5 | N/A | 0% (RLL 4%) | 3.2% (TKA), 6.3% (RTKA) | N/A |
| Johnson et al. | 2019 | 21 TKA (age < 60) | Cemented | Sigma TC3 (DePuy) | Cy (Co)* | 5.5 | Survival 100% | 0% (RLL 52%) | 0% | |
| Panda et al. | 2019 |
79 (20 TKA, 59 RTKA) & cones |
Cementless | 67% LCCK, 33% RHK (Zimmer) | Cy | 6.6 | Survival 95% | 0% (RLL 8.9%) | 2.5% | 26.6% Compli, 5% ReOP |
| Gill et al. | 2020 |
43 (12 TKA 31 RTKA & sleeves) |
Cementless | 32.6% Sigma PS, 44.2% Sigma TC3, 23.3% S-ROM Noiles (DePuy) | Cy | 5.4 | N/A | 0% (RLL 4.6%) | 2.3% | 0% ReRTKA |
| Mancino et al. | 2020 | 49 TKA |
93.4% (short) cemented 6.4% (long) cementless |
NexGen LCCK (Zimmer) | Cy | 9 | survival 93.6% (100% for AL) | 0% | 4.3% | N/A |
| Backer et al. | 2012 | 964 TKA | N/A | various RH prostheses | N/A | 5 | 5y-survival 96.98% | 0.3% | 0.8% | 2% RTKA |
| Martin et al. | 2016 | 28.667 TKA | N/A | 427 CCK, 246 RH (DePuy, Zimmer, Stryker) | N/A | 10.1 |
10y-survival 90% (CCK) and 74.6% (RH) 20y-survival 72.8% (CCK) & 40.3% (RH) |
4.4% (CCK), 6.1% (RH) | 1.2% (CCK), 3.7% (RH) | RTKA: 7.3% (CCK), 17.1% (RH) |
| Tripathi et al. | 2016 | 100 TKA (BMI > 30) | N/A | CCK prostheses | N/A | 7 | N/A | 1% | 1% | N/A |
| Siqueira et al. | 2017 | 685 (247 TKA, 315 aseptic RTKA, 123 septic RTKA) | 82% Cemented | various RH prostheses | N/A | 8.2 |
TKA: 10y-survival 88.5% RKTA: 10y-survival 75.8% (asept) 54.6% (sept) |
TKA: 0.8% RTKA: 1.9% |
TKA: 5.3% RTKA: 22.8% |
N/A |
FU follow up, AL aseptic loosening, PJI periprosthetic joint infection, TKA total knee arthroplasty, RTKA revision total knee arthroplasty, f femoral, t tibial, N/A not available, Co conical, Cy cylindrical, Cy-Co cylindrical-conical combined designs, y years, RLL radiolucent lines, ReRTKA re-revision of TKA implants, Compli complications, ReOP re-operation