Midterm Results of the Vanguard SSK Revision Total Knee Arthroplasty System

摘要

Revision total knee arthroplasty (TKA) is becoming increasingly common as the population ages and the number of existing primary TKAs continues to increase. Revision TKA systems use a greater range of component modularity than primary TKA systems, including stems, augments, and varying levels of constraint. The purpose of this study was to retrospectively review the authors' institution's use of one specific revision knee implant system and its midterm results. The Vanguard SSK Revision Knee System (Biomet, Warsaw, Indiana) was implanted 297 times in 272 patients between 2005 and 2013. Average patient age was 67.2 years, average body mass index was 33 kg/m(2), and average follow-up was 4.8 years. The most common diagnoses leading to use of this system were failed previous TKA (45.5%) and periprosthetic infection (23.2%). The SSK system was used in 78 (26.3%) complex primary TKAs at the discretion of the operating surgeon. There were 22 failures: 12 septic and 10 aseptic. Of the 12 infections, 6 occurred after 2-staged treatment of periprosthetic joint infection, with all 6 of these reinfections having a different causative organism. Aseptic failures included aseptic loosening (n=3), periprosthetic fracture (n=2), patellar maltracking (n=2), instability (n=1), arthrofibrosis (n=1), and extensor mechanism disruption (n=1). Aseptic implant survivorship was 97.2%, 95.6%, 93.1%, and 93.1% at 1, 3, 5, and 7 years postoperatively, respectively. The Vanguard SSK demonstrates excellent performance at medium-range follow-up with respect to complications, clinical scores, and prosthesis survivorship.