Stemmed femoral implants show lower failure rates in revision total knee arthroplasty☠☠â˜

•We compared revision TKA outcomes for femoral implants with or without stems.•Femoral implants without stems had unacceptable re-revision rates (44%).•Stemmed femoral implants had acceptable re-revision rates (9%).

BackgroundStemmed femoral implants are not universally used in revision total knee arthroplasty. The aim of this study was to evaluate whether the re-revision rate would be greater for revision total knees performed without stemmed femoral implants compared with revision total knees performed with stemmed femoral implants.MethodsAll revision cases performed at a single institution between 2004 and 2011 were retrospectively reviewed. A total of 130 revision total knee arthroplasty procedures (63 Group 1; 67 Group 2) met the inclusion criteria.ResultsRevisions performed without femoral stems failed more often than revisions with femoral stems (44% vs 9%, p < 0.001) despite more severe pre-operative bone loss in groups that were revised with stems (p < 0.05).ConclusionsWe recommend that femoral stems be used routinely in procedures where a femoral implant is revised following a prior total knee arthroplasty.