Document Type : RESEARCH PAPER
Hip and Knee Reconstructive Surgery Department, Humanitas Gavazzeni, Bergamo, Italy
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
Orthopedic Oncology Division, Rizzoli Orthopedic Institute, Bologna, Italy
Background: To evaluate the clinical and radiological outcomes of aseptic revision of total knee arthroplasty (TKA)
using the Vanguard 360 Revision Knee System with the hybrid cementation technique.
Methods: Between January 2014 and October 2016, nineteen aseptic revision TKAs were carried out with the Vanguard
360 Revision Knee System (Zimmer-Biomet, Warsaw, IN, USA) performed by two different surgeons. The patients were
evaluated clinically and radiographically at one, six, and twelve months after surgery and yearly thereafter. Functional
outcomes were assessed according to the range of motion (ROM), knee society knee score (KSKS) and knee society
function score (KSFS). Radiological evaluations were performed using the hip-knee-ankle angle (HKA), weight-bearing
anteroposterior view, latero-lateral view, Rosenberg x-rays of the knee and skyline patellar x-rays. A triple-phase
technetium bone scan was performed on all the patients complaining of knee pain after one year from surgery.
Results: Clinical and radiological results including KSKS, KSFS, ROM and HKA angle improved after revision of
TKA with a statistically significant difference (P<0.05). There were seven revisions of the CCK prosthesis due to
Conclusion: Patients who underwent revision of TKA using the Vanguard 360 with the hybrid cementation technique
had a failure rate of 36.8% at a mean time of 29 months due to aseptic loosening. Further studies are required to
analyse the role of cementation in detail to prevent this complication.
Level of evidence: IV