All-cementless Revision Total Knee Arthroplasty Using a Constrained Condylar Design With Porous Tantalum: Technique and Clinical Results

Introduction: Contemporary differences exist with regards to revision total knee arthroplasty (TKA) fixation philosophy. The use of an all-cementless constrained condylar knee (CCK) design for revision TKA with porous tantalum has not been described in the recent peer-reviewed literature. Our rationale for using an all-cementless design in the revision setting includes the theoretical decrease in aseptic loosening and enhanced preservation of bone stock. Methods: We report the surgical technique and clinical results of 28 patients who underwent revision TKA utilizing an all-cementless CCK design and review the complications, rerevisions, and survivorship free of aseptic loosening. All subjects were included in the survivorship analysis. Results: The mean age of patients was 62.8 years. The average length of follow-up was 3.6 years (range: 2 to 6 y). Seventeen patients underwent revision TKA for periprosthetic joint infection as the second stage of a 2-stage reconstruction, 7 for aseptic loosening, and 4 for instability. There were 6 failures defined as the removal of any components for any reason; 5 of the 6 failures were due to recurrent periprosthetic joint infection. There were no failures that were revised for aseptic loosening. Discussion: If we consider those patients lost to follow-up to represent a failure (5/28), our series would have an 82.1% survivorship free from aseptic loosening and a failure rate 17.9% at an average of 3.6 years. Early results suggest the use of an all-cementless CCK design with porous tantalum for revision TKA may provide an acceptable alternative to cemented and hybrid techniques in selected patients.