Augments and Allografts in Revision Total Knee Arthroplasty

Hockman, David E.; Ammeen, Deborah J.; Engh, Gerard A.

doi:10.1016/j.arth.2004.09.059

Cited by 81 publications

(22 citation statements)

References 15 publications

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“…The studies available that have evaluated the safety and effectiveness of using homologous structural grafts from musculoskeletal tissue banks during revision surgery present limited numbers of cases and lack long-term postoperative follow-up. 20 , 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

Use of a trabecular metal cone made of tantalum, to treat bone defects during revision knee arthroplasty

Mozella¹,

Olivero²,

Alexandre³

et al. 2014

Revista Brasileira de Ortopedia (English Edition)

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Objectivesthe aim of this study was to evaluate the surgical technique and determine the initial results, with a minimum follow-up of two years, from total knee arthroplasty revisions in which trabecular metal cones made of tantalum were used at the Knee Surgery Center of the National Institute of Traumatology and Orthopedics (INTO) or at the authors’ private clinic between July 2008 and December 2010.Methodsten patients were included in the study prospectively, through clinical and radiographic evaluations.Resultsseven patients presented evolution without complications relating to the tantalum cones used. Five of these patients said that they did not have any pain and all of them were able to walk without needing crutches. In all the cases, we observed that osseointegration of the tantalum cones had occurred. No migration or loosening of the implants was observed, nor was osteolysis.Conclusionuse of trabecular metal cones made of tantalum for treating AORI type II or II bone defects was capable of providing efficient structural support to the prosthetic revision implants, in evaluations with a short follow-up.

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Section: Discussionmentioning

confidence: 99%

Use of a trabecular metal cone made of tantalum, to treat bone defects during revision knee arthroplasty

Mozella¹,

Olivero²,

Alexandre³

et al. 2014

Revista Brasileira de Ortopedia (English Edition)

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“…Cortical allograft bone was used to treat large segmental defects, while cavitary defects were filled with cancellous allograft or autograft bone [25]. Management of bone deficiency with bulk allograft had a reported survivorship of 79.4% to 83% at 8 years of followup [22, 23]. An 85% survivorship was reported at an average of 4.2 years of followup [26].…”

Section: Resultsmentioning

confidence: 99%

Treatment for Wear and Osteolysis in Well-Fixed Uncemented TKR

et al. 2013

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Background. Traditionally, osteolysis around total knee replacements (TKRs) is treated with complete revision. In certain subsets, polyethylene insert exchange and bone grafting may be applicable. This study reports the clinical outcomes for selective bone grafting in patients with osteolysis without complete revision of the TKR. Methods. This retrospective study analyzes 10 TKRs (9 patients, 66.5 ± 6.1 years old) presenting with osteolysis and revised after 8.7 ± 1.9 years of in vivo function. At index TKR, all patients were implanted with uncemented prosthesis and modular polyethylene insert with anteroposterior articular constraint (Ultracongruent, Natural Knee II, Sulzer Medica). The surgical technique for treating the osteolysis included removal of necrotic bone tissue using curettage, filling of the defect with bone graft materials, and polyethylene insert exchange. Results. Patients have not exhibited any further complications associated with osteolysis after 5.1 ± 2.4 years of followup. Routine radiographic exams show total incorporation of the graft material into the previously lytic regions in all patients. Conclusion. In some TKRs with osteolysis and firmly fixed components, the removal of lytic tissue and subsequent defect filling with bone graft materials can be a viable solution. This case series shows complete resolution of osteolysis in all patients with no complications.

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“…According to some authors the best results came from augments using a graft. The failure rate for augments used alone stood at 48 % compared to only 19.2 % in the case of graft combination [32].…”

Section: Aori Type IImentioning

confidence: 96%