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Use of a Cemented, Long-Stem Implant for Artificial Knee Joint Revision

What to do? Your knee joint replacement needs replacement (a procedure called artificial joint revision). But your bone is thin and has lost density. It may not be strong enough to support another joint implant.

You may be a good candidate for an implant with a long stem placed down deep into the lower leg bone bone. This type of stem is called an intramedullary stem. Doctors at the Mayo Clinic advise using cement to hold this type of stem in place. Cement is used when the area of bone-to-implant contact is limited.

How well does this treatment choice hold up over time? The results of this study are positive for this option, even after 10 years. In almost 97 percent of the cases, the implant held up well, and no further surgery was needed.

There is an ongoing debate about whether cement is needed or not. Using cement gives a firm hold right away, but it's harder to remove the implant later if there's a problem. Antibiotics can be mixed in with the cement to prevent infections.

This was the longest study ever of cemented, long-intramedullary stem use in knee joint implants. The doctors at Mayo are satisfied that cement should be used with most stems of this type. They advise using cement when the joint has to be revised after the first implant fails and when bone density is decreased.

References: Andrew L. Whaley, MD, et al. Cemented Long-Stem Revision Total Knee Arthroplasty. In The Journal of Arthroplasty. August 2003. Vol. 18. No. 5. Pp. 592-599.

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