INTRODUCTION: The management of bone loss is a crucial aspect of the revision knee arthroplasty. Bone loss can hinder the correct positioning and alignment of the prosthetic components, and can prevent the achievement of a stable bone-implant interface. There is still controversy regarding the optimal management of knee periprosthetic bone loss, especially in large defects for which structural grafts, metal or tantalum augments, tantalum cones, porous metaphyseal sleeves, and special prostheses have been advocated. The aim of this review was to analyze all possible causes of bone loss and the most advanced strategies for managing bony deficiency within the knee joint reconstruction. MATERIALS AND METHODS: Most significant and recent papers about the management of bone defects during revision knee arthroplasty were carefully analyzed and reviewed to report the most common causes of bone loss and the most effective strategies to manage them. RESULTS: Modular metal and tantalum augmentation showed to provide more stable and durable knee revisions compared to allografts, limited by complications such as graft failure, fracture and resorption. Moreover, modular augmentation may considerably shorten operative times with a potential decrease of complications, above all infection which has been frequently associated to the use of allografts. CONCLUSIONS: Modular augmentation may significantly reduce the need for allografting, whose complications appear to limit the long-term success of knee revisions.
INTRODUCTION: The management of bone loss is a crucial aspect of the revision knee arthroplasty. Bone loss can hinder the correct positioning and alignment of the prosthetic components, and can prevent the achievement of a stable bone-implant interface. There is still controversy regarding the optimal management of knee periprosthetic bone loss, especially in large defects for which structural grafts, metal or tantalum augments, tantalum cones, porous metaphyseal sleeves, and special prostheses have been advocated. The aim of this review was to analyze all possible causes of bone loss and the most advanced strategies for managing bony deficiency within the knee joint reconstruction. MATERIALS AND METHODS: Most significant and recent papers about the management of bone defects during revision knee arthroplasty were carefully analyzed and reviewed to report the most common causes of bone loss and the most effective strategies to manage them. RESULTS: Modular metal and tantalum augmentation showed to provide more stable and durable knee revisions compared to allografts, limited by complications such as graft failure, fracture and resorption. Moreover, modular augmentation may considerably shorten operative times with a potential decrease of complications, above all infection which has been frequently associated to the use of allografts. CONCLUSIONS: Modular augmentation may significantly reduce the need for allografting, whose complications appear to limit the long-term success of knee revisions.
Authors: Federico Sacchetti; Raphael Kilian; Francesco Muratori; Stephane Cherix; Lorenzo Foschi; Riccardo Morganti; Domenico Andrea Campanacci; Rodolfo Capanna Journal: Arch Bone Jt Surg Date: 2022-05
Authors: Ittai Shichman; Christian Oakley; Jore H Willems; Gijs G van Hellemondt; Petra Heesterbeek; Joshua Rozell; Scott Marwin; Ran Schwarzkopf Journal: Arch Orthop Trauma Surg Date: 2022-10-15 Impact factor: 2.928
Authors: David Christopher Kieser; Derek Thomas Cawley; Takashi Fujishiro; Celeste Tavolaro; Simon Mazas; Louis Boissiere; Ibrahim Obeid; Vincent Pointillart; Jean Marc Vital; Olivier Gille Journal: Asian Spine J Date: 2018-10-18
Authors: Brianna Fram; Eric B Smith; Gregory K Deirmengian; John A Abraham; John Strony; Michael B Cross; Danielle Y Ponzio Journal: Arthroplast Today Date: 2020-01-28