Bone loss management in total knee revision surgery

Panegrossi, Gabriele; Ceretti, Marco; Papalia, Matteo; Casella, Filippo; Favetti, Fabio; Falez, Francesco

doi:10.1007/s00264-013-2262-1

Cited by 75 publications

(83 citation statements)

References 46 publications

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“…1,8,17,22 Bone loss has also developed around the joint prosthesis in patients who have undergone large joint replacement. The etiology of bone loss has not yet been determined.…”

Section: Discussionmentioning

confidence: 99%

Bone loss of vertebral bodies at the operative segment after cervical arthroplasty: a potential complication?

Heo

Lee

et al. 2017

FOC

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OBJECTIVE Bony overgrowth and spontaneous fusion are complications of cervical arthroplasty. In contrast, bone loss or bone remodeling of vertebral bodies at the operation segment after cervical arthroplasty has also been observed. The purpose of this study is to investigate a potential complication—bone loss of the anterior portion of the vertebral bodies at the surgically treated segment after cervical total disc replacement (TDR)—and discuss the clinical significance. METHODS All enrolled patients underwent follow-up for more than 24 months after cervical arthroplasty using the Baguera C disc. Clinical evaluations included recording demographic data and measuring the visual analog scale and Neck Disability Index scores. Radiographic evaluations included measurements of the functional spinal unit's range of motion and changes such as bone loss and bone remodeling. The grading of the bone loss of the operative segment was classified as follows: Grade 1, disappearance of the anterior osteophyte or small minor bone loss; Grade 2, bone loss of the anterior portion of the vertebral bodies at the operation segment without exposure of the artificial disc; or Grade 3, significant bone loss with exposure of the anterior portion of the artificial disc. RESULTS Forty-eight patients were enrolled in this study. Among them, bone loss developed in 29 patients (Grade 1 in 15 patients, Grade 2 in 6 patients, and Grade 3 in 8 patients). Grade 3 bone loss was significantly associated with postoperative neck pain (p < 0.05). Bone loss was related to the motion preservation effect of the operative segment after cervical arthroplasty in contrast to heterotopic ossification. CONCLUSIONS Bone loss may be a potential complication of cervical TDR and affect early postoperative neck pain. However, it did not affect mid- to long-term clinical outcomes or prosthetic failure at the last follow-up. Also, this phenomenon may result in the motion preservation effect in the operative segment after cervical TDR.

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“…1,8,17,22 Bone loss has also developed around the joint prosthesis in patients who have undergone large joint replacement. The etiology of bone loss has not yet been determined.…”

Section: Discussionmentioning

confidence: 99%

Bone loss of vertebral bodies at the operative segment after cervical arthroplasty: a potential complication?

Heo

Lee

et al. 2017

FOC

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“…Comorbidities, such as dementia, polyarthritis, hemiplegia, coronary heart disease, diabetes, or obesity, are disproportionately frequent in this elderly patient population increasing the risk of perioperative and implant associate complications as well as limiting the expected functional outcome. Different surgical reconstruction methods, such as allograft augmentation for large bone defects, different types of arthrodesis, or even amputations have been described in small series for these exceptionally demanding cases [3,[10][11][12][13][14]. Modular-hinged implants provide the opportunity of bridging large bone defects and restoring a stable joint situation even when stabilizing ligaments structures have been lost in prior operations [15][16][17].…”

Section: Discussionmentioning

confidence: 98%

Knee salvage in revision arthroplasty after massive bone loss of the femur condyles (≥Engh III) with a single-modular-hinged knee revision implant

Streitbuerger

Hardes

Gosheger

et al. 2016

Arch Orthop Trauma Surg

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In consideration of this complex study, population acceptable functional results can be achieved using a modular knee revision endoprosthesis. In younger patients (<60 years), satisfying results in terms of walking ability and overall satisfactory can be expected. The outcome in older multimorbid patients is worse. Yet, operation in these patients can be feasible to restore enough mobility for daily household activities.

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“…Where the fractures are markedly comminuted, or where bone stock is not available, distal fracture fragment excision with replacement of the distal femur can be considered. The reconstruction is either with a structural allograft or by some form of distal femoral replacement [21,22]. The major disadvantage of the technique is that the tibial component, often well-fixed, has to be revised in addition to the femoral component.…”

Section: Classification Systemsmentioning

confidence: 99%