• Sanjeev Agarwal, Devdatta Suhas Neogi, and Rhidian Morgan-Jones.
• Department of Trauma & Orthopaedics, Cardiff & Vale Orthopaedic Centre, University Hospital Llandough, Cardiff & Vale University Health Board, Cardiff, United Kingdom.
• Knee. 2018 Dec 1; 25 (6): 1299-1307.

BackgroundMetal metaphyseal sleeves are an option for reconstruction as well as enhancing fixation in managing challenging bone defects in revision knee replacement. We report our results of revision knee replacement using metaphyseal sleeves with a minimum of seven years of follow-up.MethodsThe records of 103 patients (104 knees) who underwent revision knee replacement using metaphyseal sleeves in our centre were evaluated. The follow-up included clinical assessment, functional scores and radiologic assessment.ResultsThe mean age of patients was 74.7 (tange 58-92) years. Mean follow-up was 95.7 (range, 88-115) months. From the original cohort, 15 (14%) patients had died from unrelated causes. During the follow-up period, there were 23 (22.1%) re-revisions. Indications for re-revision was aseptic loosening in seven (6.7%), stiffness in four (3.8%), infection in five (4.8%), instability in three (2.8%) and persistent pain in two (1.9%) patients. For aseptic loosening, the average time for re-revisions was 56.6 months (range 25 to 84). Radiographically, all unrevised sleeves were well-fixed, without any evidence of loosening. Oxford knee score in patients without re-revisions was 28.5 (range four to 48).ConclusionAt mid-term follow-up, metaphyseal sleeves demonstrate durable clinical results and radiographic fixation.Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

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