Page 191 - Reconstructive Techniques in Musculoskeletal Tumor Surgery

type 1 complications. No type 1 complication resulted in removal or revision of the prosthesis.
Aseptic loosening (Henderson type 2) occurred in 15 distal femoral replacements (15 of 89 [17%]) and two proximal tibial replacements (two of 21 [10%]) after a median of 1.2 years (range, 0.5 – 15 years). Both proximal tibial replacements had loosening of the femoral component (both uncemented, one HA-coated), for which cemented re- xation was undertaken. Of the 15 distal femoral replacements, nine had loosening of the femoral component, three of the tibial component, and three of both components. Treatment consisted of cemented re- xation (n = 6), uncemented revision of the femoral component (n = 4), cemented revision (n = 4), and a total femoral replacement (as a result of poor remnant host bone) (n = 1). With the numbers we had, for uncemented distal femoral replacements, we could not detect an association between reconstruction length and the rate of loosening (hazard ratio [HR], 1.06; 95% CI, 0.93 – 1.21; p = 0.393) nor a di erence in loosening between revision ( ve of 17 [29%]) and primary reconstructions (eight of 61 [13%]) (HR, 1.72; 95% CI, 0.55 – 5.38; p = 0.354). Uncemented HA-coated distal femoral replacements had a lower risk of loosening (two of 42 [5%]) than uncemented uncoated implants (11 of 36 [31%]) (HR, 0.23; 95% CI, 0.05 – 1.06; p = 0.060) ( gure 2).
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MUTARS knee replacement
Figure 2. Kaplan-Meier curve showing survival to the occurrence of loosening for uncemented uncoated (blue line, n = 36) and uncemented HA-coated (green line, n = 42) distal femoral replacements.
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