{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T01:22:57Z","timestamp":1769908977190,"version":"3.49.0"},"reference-count":17,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T00:00:00Z","timestamp":1579564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T00:00:00Z","timestamp":1579564800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T00:00:00Z","timestamp":1579564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to compare the clinical results, radiographic loosening and early complications between patients undergoing primary knee arthroplasty (TKA) with tibial short stem extension and those with standard stem for gross varus deformities at minimum two years after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From a prospective TKA database of 4216 patients, patients with a primary TKA with a tibial short stem extension (30\u00a0mm) for severe varus deformity (hip\u2010kneeankle angle, HKA\u2009&lt;\u2009170\u00b0) and a minimum follow\u2010up of 2 years, were reviewed and compared to a matched control group with tibial components with a standard stem, in a<\/jats:p><jats:p>1:3 ratio. Demographics, surgical parameters, pre\u2010 and postoperative alignment and outcome parameters were collected for all patients. The primary outcome was aseptic loosening of the tibial component. Secondary outcomes were knee society scores (KSS), postoperative HKA, general postoperative complications and implant survival rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010five patients with tibial short stem extensions (mean HKA 166.2\u00b0) were compared in a 1:3 ratio to a matched case\u2013control group of 135 patients with standard stems (mean HKA 167.1\u00b0) at a mean follow\u2010up of 57 and 64\u00a0months respectively after primary TKA. In the extension stem group, 4 patients encountered complications<\/jats:p><jats:p>(8.9%) versus 12 patients in the standard stem group (8.9%). There were no cases of tibial component loosening in the short extension stem versus four cases in the standard stem group (3%). This difference was significant between groups, <jats:italic>p<\/jats:italic>\u2009=\u20090.04.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with varus deformities\u2009&gt;\u200910\u00b0, undergoing primary total knee arthroplasty, prophylactic use of a tibial short extension stem may lead to less loosening of the tibial component. In this study, 3% of patient with big varus deformity without stemmed TKA had a tibial implant loosening versus 0% in the stemmed TKA group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level III, case\u2013control study<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-05848-2","type":"journal-article","created":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T10:03:25Z","timestamp":1579601005000},"page":"3780-3786","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Increased survival rate for primary TKA with tibial short extension stems for severe varus deformities at a minimum of 2 years follow\u2010up"],"prefix":"10.1002","volume":"28","author":[{"given":"Gaspard","family":"Fournier","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery and Sport Medicine Croix\u2010Rousse Hospital, FIFA Medical Center of Excellence Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart","family":"Muller","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery and Sport Medicine Croix\u2010Rousse Hospital, FIFA Medical Center of Excellence Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romain","family":"Gaillard","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery and Sport Medicine Croix\u2010Rousse Hospital, FIFA Medical Center of Excellence Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9cile","family":"Batailler","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery and Sport Medicine Croix\u2010Rousse Hospital, FIFA Medical Center of Excellence Lyon France"},{"name":"<!--<label>2<\/label>--> Univ Lyon, Universit\u00e9 Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406 69622 Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9bastien","family":"Lustig","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery and Sport Medicine Croix\u2010Rousse Hospital, FIFA Medical Center of Excellence Lyon France"},{"name":"<!--<label>2<\/label>--> Univ Lyon, Universit\u00e9 Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406 69622 Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elvire","family":"Servien","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery and Sport Medicine Croix\u2010Rousse Hospital, FIFA Medical Center of Excellence Lyon France"},{"name":"<!--<label>3<\/label>--> EA 7424 \u2010 Interuniversity Laboratory of Human Movement Science Universit\u00e9 Lyon 1 Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,1,21]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2017.05.010"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010016\u20104227\u20106"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010014\u20103269\u2010x"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.04.055"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2016.08.015"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010014\u20103529\u20106"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200112000\u201000014"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2016.07.007"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.08.001"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0177285"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2012.11.014"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.03.058"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.K.00607"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.01.012"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.94B8.28289"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2007.04.004"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010015\u20103820\u20104"}],"container-title":["Knee 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September 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 January 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. GF, BM, CB and RG declare that they have no conflict of interest. SL: consultant for Smith and Nephew, Stryker, Medacta, Heraeus, Depuy Synthes, Groupe Lepine, institutional research support from Corin and Amplitude. ES: institutional research support from Corin.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All the procedures performed in the study were in accordance with the ethical standards of the institutional review board\/international ethics commitee for each center and with the 1964 Helsinki Declaration and its later amendments.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}