Advertisement
Case Report| Volume 27, ISSUE 8, P1580.e5-1580.e7, September 2012

Tibial Stem Tip Pain in Stemmed Revision Total Knee Arthroplasty

Treatment with Tension Band Plating
Published:March 07, 2012DOI:https://doi.org/10.1016/j.arth.2011.12.032

      Abstract

      The use of stemmed modular components in revision total knee arthroplasty has led to increasingly described pain located at the tip of the stem of the implant. This has been described in the literature as being due to the elastic modulus mismatch between the stem tip and the host bone. Current management is re-revision total knee arthroplasty in an attempt to alleviate the mismatch. This case report describes a novel technique using a dynamic compression plate acting as a tension band at the stem tip to successfully treat this condition.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Arthroplasty
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Haas S.B.
        • Insall J.N.
        • Montgomery W.
        • et al.
        Revision total knee arthroplasty with use of modular components with stems inserted without cement.
        J Bone Joint Surg Am. 1995; 77: 1700
        • Bourne R.B.
        • Crawford R.A.
        Principles of revision total knee arthroplasty.
        Orthop Clin North Am. 1998; 29: 331
        • Elia E.A.
        • Lotke P.A.
        Results of revision total knee arthroplasty associated with significant bone loss.
        Clin Orthop Relat Res. 1991; 271: 114
        • Engh G.A.
        • Herzurm P.J.
        • Parks N.L.
        Treatment of major defects of bone with bulk allografts and stemmed components during total knee arthroplasty.
        J Bone Joint Surg [Am]. 1997; 79: 1030
        • Barrack R.L.
        • Rorabeck C.
        • Burt M.
        • et al.
        Pain at the end of the stem after revision total knee arthroplasty.
        Clin Orthop Relat Res. 1999; 367: 216
        • Whaley A.L.
        • Trousdale R.T.
        • Rand J.A.
        • et al.
        Cemented long-stem revision total knee arthroplasty.
        J Arthroplasty. 2003; 18: 592
        • Peters C.L.
        • Erickson J.
        • Kloepper R.G.
        • et al.
        Revision total knee arthroplasty with modular components inserted with metaphyseal cement and stem without cement.
        J Arthroplasty. 2005; 20: 302
        • Glenn J.C.
        • Sokoloski S.N.
        • Damer B.M.
        • et al.
        Tibia pain at end of stem with stemmed revision total knee arthroplasty: treatment with cortical strut graft technique.
        J Arthroplasty. 2010; 25: 497
        • Borens O.
        • Sen M.K.
        • Huang R.C.
        • et al.
        Anterior tension band plating for anterior tibial stress fractures in high-performance female athletes.
        J Orthop Trauma. 2006; 20: 425
        • Kitchener M.
        • Coats E.
        • Keene G.
        • et al.
        Assessment of radionuclide arthrography in the evaluation of loosening of knee prostheses.
        Knee. 2006; : 220
        • Cameron H.U.
        • Jung Y.B.
        Noncemented stem tibial component in total knee replacement: the 2- to 6-year results.
        Can J Surg. 1993; 36: 555
        • Barrack R.L.
        • Stanley T.
        • Burt M.
        • et al.
        The effect of stem design on end-of-stem pain in revision total knee arthroplasty.
        J Arthroplasty. 2004; 19: 119
        • Hofmann A.A.
        • Wyatt R.W.
        • Daniels A.U.
        • et al.
        Bone scans after total knee arthroplasty in asymptomatic patients. Cemented versus cementless.
        Clin Orthop Relat Res. 1990; 251: 183