PROMOTIONAL FEATURE
Interprosthetic fractures can be successfully and permanently stabilised with special prostheses such as the RescueSleeve from LINK – as confirmed by studies [1-5]. Effective stabilisation is also achieved when LINK prostheses are combined with implants from other manufacturers
The increasing use of stemmed prostheses today means that the stems of hip and knee prostheses often have to be coupled in the femur. According to Soenen et al [1], the risk of interprosthetic fracture increases dramatically if the distance between the stem tips is less than 100mm. Weiser et al [2], on the other hand, concluded that the distance between the stem tips has scarcely any influence on the risk of fracture, but rather the bone quality of the cortex is the decisive factor. Irrespective of the cause of these interprosthetic fractures, they can be effectively and permanently stabilised with custom-made prostheses. Very good results have been achieved with sleeve couplings, like the RescueSleeve from LINK, for stem-stem coupling [3]. This applies both to LINK® stems and to combinations of LINK prostheses with implants from other manufacturers.
Anatomical angle between the connection components is possible
Essentially, the sleeves can be either single-ended or double-ended (twin sleeve). In the case of the single-ended version, the component that is in contact with the sleeve can consist of an intramedullary stem or a joint component that anchors the prosthesis, which is held by the sleeve, in the medullary canal, or connects it to another joint. Figure 1 shows an example for a single-sided RescueSleeve which connects an in-situ Wagner hip stem to LINK MEGASYSTEM-C® components and Endo-Model® rotational knee prosthesis after recurrent periprosthetic fracture. The double-ended sleeve (Figure 2), on the other hand, connects the two opposing stemmed prostheses following an interprosthetic fracture. Figure 3 shows a case example for a twin RescueSleeve that connects an in-situ Wagner hip stem with a stemmed knee prosthesis after interprosthetic fracture.
Figure 1: Case example for recurrent periprosthetic fractures. Single-sided RescueSleeve to Wagner stem with modular connection to MEGASYSTEM-C Rotational Knee with modular proximal tibia replacement. A) pre-operative proximal situation: Wagner revision stem on left side. B) pre-operative distal condition: knee TKA with recurrent periprosthetic fractures. C) The custom implant: proximal RescueSleeve for coupling with in-situ Wagner stem connected to Megasystem-C component and Endo-Model Rotational Knee prosthesis. D) post-operative X-rays.
Figure 2: Available as a custom-made product: The LINK Twin