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


Authors: Healey, J. H.; Morris, C. D.; Athanasian, E. A.; Boland, P. J.
Article Title: Compress knee arthroplasty has 80% 10-year survivorship and novel forms of bone failure
Abstract: 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. 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. 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. 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. 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 IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
Keywords: adolescent; adult; treatment outcome; middle aged; recovery of function; retrospective studies; young adult; mortality; pathophysiology; neoplasm recurrence, local; pathology; retrospective study; time; time factors; postoperative complication; postoperative complications; instrumentation; tumor recurrence; reoperation; knee; radiography; kaplan meier method; convalescence; prosthesis; bone necrosis; osteonecrosis; weight bearing; femur tumor; arthroplasty, replacement, knee; periprosthetic fracture; prosthesis design; prosthesis failure; kaplan-meier estimate; range of motion, articular; biomechanics; femoral neoplasms; joint characteristics and functions; knee joint; knee arthroplasty; knee prosthesis; periprosthetic fractures; weight-bearing
Journal Title: Clinical Orthopaedics and Related Research
Volume: 471
Issue: 3
ISSN: 0009-921X
Publisher: Springer  
Date Published: 2013-03-01
Start Page: 774
End Page: 783
Language: English
PUBMED: 23054526
PROVIDER: scopus
PMCID: PMC3563794
DOI: 10.1007/s11999-012-2635-6
DOI/URL:
Notes: --- - "Export Date: 1 May 2013" - ":doi 10.1007/s11999-012-2635-6" - "Source: Scopus"
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MSK Authors
  1. Patrick J Boland
    149 Boland
  2. Carol Morris
    55 Morris
  3. John H Healey
    478 Healey