Compress® knee arthroplasty has 80% 10-year survivorship and novel forms of bone failure knee

John H. Healey, Carol D Morris, Edward A. Athanasian, Patrick J. Boland

Research output: Contribution to journalArticle

Abstract

Background: Compliant, self-adjusting compression technology is a novel approach for durable prosthetic fixation of the knee. However, the long-term survival of these constructs is unknown. Questions/purposes: We therefore determined the survival of the Compress® prosthesis (Biomet Inc, Warsaw, IN, USA) at 5 and 10 actuarial years and identified the failure modes for this form of prosthetic fixation. Methods: We retrospectively reviewed clinical and radiographic records for all 82 patients who underwent Compress® knee arthroplasty from 1998 to 2008, as well as one patient who received the device elsewhere but was followed at our institution. Prosthesis survivorship and modes of failure were determined. Followup was for a minimum of 12 months or until implant removal (median, 43 months; range, 6-131 months); 28 patients were followed for more than 5 years. Results: We found a survivorship of 85% at 5 years and 80% at 10 years. Eight patients required prosthetic revision after interface failure due to aseptic loosening alone (n = 3) or aseptic loosening with periprosthetic fracture (n = 5). Additionally, five periprosthetic bone failures occurred that did not require revision: three patients had periprosthetic bone failure without fixation compromise and two exhibited irregular prosthetic osteointegration patterns with concomitant fracture due to mechanical insufficiency. Conclusions: Compress® prosthetic fixation after distal femoral tumor resection exhibits long-term survivorship. Implant failure was associated with patient nonadherence to the recommended weightbearing proscription or with bone necrosis and fracture. We conclude this is the most durable FDA-approved fixation method for distal femoral megaprostheses. Level of Evidence: Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)774-783
Number of pages10
JournalClinical Orthopaedics and Related Research
Volume471
Issue number3
DOIs
StatePublished - Mar 2013
Externally publishedYes

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Knee Replacement Arthroplasties
Knee
Survival Rate
Bone and Bones
Thigh
Periprosthetic Fractures
Prosthesis Failure
Osteonecrosis
Cimetidine
Bone Fractures
Weight-Bearing
Patient Compliance
Prostheses and Implants
Technology
Equipment and Supplies
Survival
Neoplasms

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Compress® knee arthroplasty has 80% 10-year survivorship and novel forms of bone failure knee. / Healey, John H.; Morris, Carol D; Athanasian, Edward A.; Boland, Patrick J.

In: Clinical Orthopaedics and Related Research, Vol. 471, No. 3, 03.2013, p. 774-783.

Research output: Contribution to journalArticle

Healey, John H. ; Morris, Carol D ; Athanasian, Edward A. ; Boland, Patrick J. / Compress® knee arthroplasty has 80% 10-year survivorship and novel forms of bone failure knee. In: Clinical Orthopaedics and Related Research. 2013 ; Vol. 471, No. 3. pp. 774-783.
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abstract = "Background: Compliant, self-adjusting compression technology is a novel approach for durable prosthetic fixation of the knee. However, the long-term survival of these constructs is unknown. Questions/purposes: We therefore determined the survival of the Compress{\circledR} prosthesis (Biomet Inc, Warsaw, IN, USA) at 5 and 10 actuarial years and identified the failure modes for this form of prosthetic fixation. Methods: We retrospectively reviewed clinical and radiographic records for all 82 patients who underwent Compress{\circledR} knee arthroplasty from 1998 to 2008, as well as one patient who received the device elsewhere but was followed at our institution. Prosthesis survivorship and modes of failure were determined. Followup was for a minimum of 12 months or until implant removal (median, 43 months; range, 6-131 months); 28 patients were followed for more than 5 years. Results: We found a survivorship of 85{\%} at 5 years and 80{\%} at 10 years. Eight patients required prosthetic revision after interface failure due to aseptic loosening alone (n = 3) or aseptic loosening with periprosthetic fracture (n = 5). Additionally, five periprosthetic bone failures occurred that did not require revision: three patients had periprosthetic bone failure without fixation compromise and two exhibited irregular prosthetic osteointegration patterns with concomitant fracture due to mechanical insufficiency. Conclusions: Compress{\circledR} prosthetic fixation after distal femoral tumor resection exhibits long-term survivorship. Implant failure was associated with patient nonadherence to the recommended weightbearing proscription or with bone necrosis and fracture. We conclude this is the most durable FDA-approved fixation method for distal femoral megaprostheses. Level of Evidence: Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.",
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