Severe tibial bone loss in revision total knee replacement managed with structural femoral head allograft

Lyall, Harpreet; Sanghrajka, Anish; Scott, G.

doi:10.1016/j.knee.2009.02.007

Cited by 25 publications

(8 citation statements)

References 21 publications

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“…Structural allograft is known for its capability of incorporating the host bone and stress protection. Literature had reported a prosthesis survival rate between 76% and 93% at a 5-year follow-up, showing the capability of structural allograft in treating knee revision cases with bone loss (9,10,25). survival rate of 92% at 5 years and 72% at 10 years in 52 patients with uncontained bone defect constructed with structural allograft in knee revisions (28).…”

Section: Structural Allogenous Bone Graftmentioning

confidence: 99%

Application of structural allogenous bone graft in two-stage exchange arthroplasty for knee periprosthetic joint infection: a case control study

Chuang

Lee

Chang

et al. 2021

Preprint

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Background: Knee prosthetic joint infection (PJI) is a common but devastating complication after knee arthroplasty. The revision surgeries for knee PJI may become more challenging when it is associated with large bone defects. The application of structural bone allograft in knee revision surgeries with large bone defects is not a new technique. However, there is a lack of literature reporting its efficacy in PJI cases. This study aimed to investigate the outcome of structural fresh frozen allogenous bone grafts in treating patients in knee PJI with large bone defects. Methods: We performed a retrospective cohort analysis of knee PJI cases treated with two-stage exchange arthroplasty at our institution from 2010 to 2016. 12 patients with structural allogenous bone graft reconstructions were identified as the study group. 24 patients without structural allograft reconstructions matched with the study group by age, gender, and Charlson comorbidity index were enrolled as the control group. The functional outcome of the study group was evaluated with the Knee Society Score (KSS). Treatment success was assessed according to the Delphi-based consensus definition. The infection relapse rate and implant survivorship were compared between groups. Results: Revision knees with structural allograft presented excellent improvement in the KSS (33.1 to 75.4). There was no significant difference between infection relapse-free survival rate and prosthesis survival rate in two groups. The 8-year prosthesis survival rate was 90.9% in the study group and 91% in the control group (p = 0.913). The 8-year infection relapse-free survival rate was 80% and 83.3% in the study group and control group, respectively (p = 0.377). Conclusion: The structural fresh frozen allogenous bone graft provided an effective way for bone defect reconstruction in knee PJI with accountable survival rate. Meanwhile, using structural allografts did not increase the relapse rate of infection.

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Section: Structural Allogenous Bone Graftmentioning

confidence: 99%

Application of structural allogenous bone graft in two-stage exchange arthroplasty for knee periprosthetic joint infection: a case control study

Chuang

Lee

Chang

et al. 2021

Preprint

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“…Several studies have demonstrated that the use of femoral head structural allograft might improve the clinical outcomes for patients with severe bone defects in RTKA. A prospective case series from the Royal London Hospital demonstrated that the use of femoral head structural allograft along with long stemmed components can achieve a successful result in the management of severe bone loss during RTKA. Chun et al .…”

Section: Bone Graftsmentioning

confidence: 99%

Bone Defects in Revision Total Knee Arthroplasty and Management

Lei

2019

Orthopaedic Surgery

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This article reviews the recent updates in revision of total knee arthroplasty (RTKA). We reviewed the recent articles on RTKA in databases including PubMed, Google Scholar, and SCOPUS. Total knee arthroplasty (TKA) involves the replacement of all three compartments of the knee in surgery of the knee joint to restore capacity and function. TKA is one of the most common and reliable surgical treatment options for the treatment of knee diseases. However, some patients require revision of TKA (RTKA) after primary TKA for various reasons, including mechanical wear, implant loosening or breakage, malalignment, infection, instability, periprosthetic fracture, and persistent stiffness. Unfortunately, the overall outcome of RTKA is not as satisfactory as for primary TKA due to the uncertainty regarding the actual success rate and the risk factors for failure. Cementation, modular metal augmentation, bone grafting, autologous bone grafting, allogenic bone grafting, impactation bone grafting, structural bone allografting, metaphyseal fixation, using porous titanium coated press fit metaphyseal sleeves and porous tantalum structural cones, and megaprostheses or customized prostheses are the currently available management options for RTKA. However, most of the management systems possess specific complications. Novel approaches should be developed to improve functional capacity, implant survival rates, and quality of life in a cost‐efficient manner.

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“…Mont et al 23 reported their series of patients with TKA who were participating in sports such as tennis, basketball, and racquetball. Less bone resection (often allows conversion to a primary TKA when it fails compared to the need for a revision knee replacement when a TKA fails) 37 5. At a mean 4-year follow-up, 32 of 33 2.…”

Section: Total Knee Arthroplastymentioning

confidence: 99%

Sports After Knee Arthroplasty: Partial Versus Total Knee Arthroplasty

Farr

Jiranek²

2009

The Physician and Sportsmedicine

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Osteoarthritis becomes more prevalent with increasing age, and currently is occurring more frequently in the "baby boomer" generation (ages 44-66 years). However, many individuals may be reluctant to undergo arthroplasty procedures because potential activity limitations. Thus, physicians must consider each patient's history and desired activity level after treatment. Osteoarthritis treatments include nonoperative measures such as weight reduction, injections, and nonsteroidal anti-inflammatory drugs, as well as operative options, including partial and total knee arthroplasty. Each treatment type will vary in its impact on activity levels. If arthroplasty is required, patients must be cautioned to minimize component overload, which may result in polyethylene wear and loosening; however, cardiopulmonary fitness and general conditioning benefits of activity can be maintained.

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Severe tibial bone loss in revision total knee replacement managed with structural femoral head allograft

Cited by 25 publications

References 21 publications

Application of structural allogenous bone graft in two-stage exchange arthroplasty for knee periprosthetic joint infection: a case control study

Application of structural allogenous bone graft in two-stage exchange arthroplasty for knee periprosthetic joint infection: a case control study

Bone Defects in Revision Total Knee Arthroplasty and Management

Sports After Knee Arthroplasty: Partial Versus Total Knee Arthroplasty

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