{"@context":"https://schema.org","@type":"ScholarlyArticle","headline":"Midterm clinical results of metaphyseal sleeves in knee revision reconstruction of bone defects: A follow-up study.","author":[{"@type":"Person","name":"Qin Wang"},{"@type":"Person","name":"Donghai Li"},{"@type":"Person","name":"Guangtao Han"},{"@type":"Person","name":"Shuo Sun"},{"@type":"Person","name":"Yajie Chen"},{"@type":"Person","name":"Pengde Kang"}],"datePublished":"2026","isPartOf":{"@type":"Periodical","name":"Journal of orthopaedic surgery (Hong Kong)"},"identifier":"https://doi.org/10.1177/10225536261422522","description":"\n Objective\n In revision total knee arthroplasty (rTKA), metaphyseal sleeves represent an effective modality for managing metaphyseal bone defects. The purpose of this study was to clearly stratify patients with different grades of metaphyseal bone defects while evaluating the mid-term clinical outcomes and survival rate of metaphyseal sleeves.\n \n \n Methods\n A retrospective study was conducted on 58 patients who underwent revision total knee arthroplasty (rTKA) with metaphyseal sleeves between May 2018 and September 2022. Bone defects were classified using the Anderson Orthopaedic Research Institute (AORI) classification system: patients with AORI type I and IIA defects were categorized as having mild bone defects, while those with AORI type IIB and III defects were defined as severe bone defects. Clinical outcomes, including the visual analog scale (VAS) for pain, range of motion (ROM), Hospital for Special Surgery (HSS) score, Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Form-12 (SF-12) health survey, were recorded preoperatively and during the entire follow-up period. Linear mixed-effects models were employed to analyze repeated-measure outcomes, and Kaplan–Meier analysis was utilized to estimate the survivorship of metaphyseal sleeves.\n \n \n Results\n \n The mean duration of follow-up was 66.6 months, with a range of 30 to 85 months. All clinical outcome metrics exhibited a statistically significant improvement compared with preoperative values (\n p\n < 0.001), and both the mild and severe defect groups demonstrated analogous postoperative recovery trajectories. No sleeve-related complications or failures were observed, including aseptic loosening, periprosthetic fracture, or deep periprosthetic infection. Kaplan–Meier analysis yielded an estimated 5-years metaphyseal sleeve survivorship of 100%.\n \n \n \n Conclusion\n These findings demonstrate that metaphyseal sleeves provide reliable midterm fixation and significant functional improvements in patients undergoing revision total knee arthroplasty (rTKA), irrespective of the severity of metaphyseal bone defects.\n ","url":"https://innscience.ca/en/community/literature/doi_10_1177_10225536261422522"}