The algorithm of metaphisal fixator choice in revision knee arthroplasty

   The aim of this research was to study the immediate and long-term outcomes of revision total knee replacement (reTNR) using metaphyseal fixators (sleeves and cones), and to design the algorithm for choosing a metaphyseal fixator.

   Material and methods. The research involved 134 patients who underwent revision knee arthroplasty. The patients were divided into two groups according to the type of metaphyseal fixator used for their surgeries: sleeves (Group 1) – 97 patients, and cones (group 2) – 37 patients. The outcomes were evaluated at their discharge from the hospital, 6, 12, 24 months after surgeries. The implants survival was analyzed with the Kaplan - Meier estimate. Reoperation with the complete replacement of the implant or its components was considered a critical event.

   Results. The analysis of the implants survival rate revealed no statistically significant differences between the groups (Logrank (the Mantel-Cox) test, p=0.108). We designed the algorithm for metaphisal fixator selection in revision knee arthroplasty and implemented it into practice.

   Conclusion. The implantation of metaphyseal sleeves or cones to replace extensive bone defects in reTNR surgeries presents similar outcomes in the mid-term. The introduction of the algorithm for choosing a metaphyseal fixator that takes into account the bone defect size, patient’s age and activity is a step towards improving the outcomes of reTNR.

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