Management of Bone Loss in Primary and Revision Knee Replacement Surgery

Fosco, M.; Ayad, R. Ben; Amendola, Luca; Tigani, Domenico

doi:10.5772/26995

Cited by 16 publications

(16 citation statements)

References 46 publications

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“…It is not preferable that the proximal tibia cut level is lower than accepted measures. [ 1 , 6 , 12 ] That is because the tibial base plate cannot be supported by softer cancellous bone and the tendons and ligaments adhering to the proximal tibia may be damaged [ 1 , 6 ]. For this reason, most of the defects of tibial medial plateau have to be reconstructed.…”

Section: Discussionmentioning

confidence: 99%

“…For this reason, most of the defects of tibial medial plateau have to be reconstructed. [ 6 ] Lee and Choi [ 8 ] used metal rectangular augments and reported successful outcomes at a minimum 5 year follow up. Reportedly, there is no difference between metal rectangular augments and metal wedges.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that iliac crest grafts, femoral and tibia cut autografts were used to biologically reconstruct the tibia medial defect. [ 1 , 2 , 5 , 6 , 18 - 21 ] We used autografts obtained from tibia cuts in the reconstruction of these defects. This was due to the fact that iliac crest graft harvesting causes morbidity in donor site and that proximal tibia cut autograft is more resistant than the femoral condyle cut autografts.…”

Section: Discussionmentioning

confidence: 99%

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Using Tibia Proximal Cut Autograft in Advanced Varus Knee Deformity in Total Knee Arthroplasty; Outcomes Compared to the Control Group

Arslan

2018

TOORTHJ

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Background:The purpose of this study was to compare the outcomes of Total Knee Arthroplasty (TKA) performed for advanced varus knee deformity, which is performed by using tibia proximal cut bone for the reconstruction of the tibia proximal medial bone defects, with a control group consisting of TKAs which did not need reconstruction.Methods:Patients in the present study underwent total knee arthroplasty between 2009 and 2015. 12 patients with advanced varus deformity who had undergone reconstruction with tibia proximal cut autograft and 15 patients who were randomly selected from patients who did not need reconstruction, were compared clinically and radiographically.Results:The mean follow-up period of the patients was found to be 73.1 ± 19.7 (36-108) months in the reconstruction group and 73.2 ± 12.3 (39-107) months in the control group. (p> 0.05) In both groups, significant improvement was observed postoperatively. In both groups, there was no evidence of loosening the required revision. WOMAC score was 32.4 ± 13.3 (8-64) in the reconstruction group and 28.9 ± 17.2 (6-70) in the control group at the last control visit. There was no difference between the groups when comparing the WOMAC scores at the last control visit. In the reconstruction group, the Hip-Knee-Ankle (HKA) angle was 26.1 ± 4.9 ° varus preoperatively and 1.3 ± 2.3 ° valgus postoperatively; and in the control group 10.1 ± 2.1 ° varus preoperatively and 2.7 ± 3.4 ° valgus postoperatively. (p> 0.05)Conclusion:In the present study, clinical and radiographic results of total knee arthroplasty patients, who suffered from advanced knee varus deformity and whose proximal tibia medial defects were reconstructed by using tibial proximal cut autograft, have been found to be successful when compared to the control group.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Using Tibia Proximal Cut Autograft in Advanced Varus Knee Deformity in Total Knee Arthroplasty; Outcomes Compared to the Control Group

Arslan

2018

TOORTHJ

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“…Fosco suggests using cement only for peripheral bone defects with an extension less than 50 % of the bone surface and less than 5 mm in depth [15].…”

Section: Aori Type Imentioning

confidence: 99%

Bone loss management in total knee revision surgery

Panegrossi

Ceretti

Papalia

et al. 2014

International Orthopaedics (SICOT)

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“…Treatment alternatives for bone defects in TKA -depending on the location, configuration (contained or non-contained) and magnitude- are bone cement, bone cement with screw reinforcement, metal augmentation, impacted bone grafts, structural allografts and tantalum. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 …”

mentioning

confidence: 99%

Short-term results of the management of severe bone defects in primary TKA with cement and K-wires

Bilgen

Eken²,

Güney

2017

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveThe aim of this study was to evaluate the results of cement and kirschner wire augmentation in the management of bone defects in primary TKA.MethodsTwenty-four patients (10 male, 14 female; mean age: 66 years) with uncontained unilateral medial tibial articular bone defect who underwent TKA between 2010 and 2014 were included in this study. The average follow up time was 33.7 months. Patients were divided to two groups according to the size of the bone defect (Group 1: <20 mm, Group 2: >20 mm). The tibial defect was reconstructed by using cement and K-wires. We used posterior stabilized prosthesis with no tibial stem extension.ResultsThe preoperative and postoperative lower extremity mechanical axis in Group I was in a mean varus of 15° and mean varus of 3°, respectively (p < 0.001). The preoperative and postoperative lower extremity mechanical axis in Group 2 was in a mean varus of 20° and mean varus of 3° respectively in Group II (p < 0.001). None of the patients neither suffered from failure of K-wires nor loosening.ConclusionThe use of cement and K-wires augmentation appears to be a simple and cost-effective treatment option for the tibial bone defects in primary TKA.Level of evidenceLevel IV, Therapeutic study.

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Management of Bone Loss in Primary and Revision Knee Replacement Surgery

Cited by 16 publications

References 46 publications

Using Tibia Proximal Cut Autograft in Advanced Varus Knee Deformity in Total Knee Arthroplasty; Outcomes Compared to the Control Group

Using Tibia Proximal Cut Autograft in Advanced Varus Knee Deformity in Total Knee Arthroplasty; Outcomes Compared to the Control Group

Bone loss management in total knee revision surgery

Short-term results of the management of severe bone defects in primary TKA with cement and K-wires

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