Modular Augmentation in Revision Total Knee Arthroplasty

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2012 Nov 1

PMID 23111826

Citations 17

Authors

Alfredo Schiavone Panni

Michele Vasso

Simone Cerciello

Affiliations

Soon will be listed here.

Abstract

Purpose: Controversy exists about the real effectiveness of modular augmentation to manage bone defects in revision total knee arthroplasty. The purpose of this study was to determine whether use of modular augmentation to reconstruct severe defects (1) significantly increased overall outcomes, (2) caused radiolucency or osteolysis and (3) affected mid-term survivorship of knee revisions. The hypothesis was that modular augmentation provides a good survivorship of knee revisions.

Methods: Thirty-eight consecutive revision knee arthroplasties were followed for a median follow-up period of 7 (4.5-9) years. Type 2 and 3 defects were treated with metal augments, tantalum cones and modular cementless stems. Patients were assessed using the IKS knee and function scores and the HSS score.

Results: The median IKS knee and function scores and HSS score were 34 (15-58), 19.5 (13-39) and 30 (24-60) points before the operation, respectively, and 78 (49-97), 76 (58-90) and 80.5 (64-98) points (p < 0.001) at the latest follow-up. The median knee flexion increased from 82° (31°-110°) to 116° (100°-129°) (p < 0.01). Tibial radiolucencies were observed in 2 (5.2 %) cases. Re-revision was necessary in three (7.9 %) patients.

Conclusions: Modular augmentation may reduce the need for allografting to treat severe bone defects, providing a well-functioning and durable knee joint reconstruction.

Citing Articles

Mid term outcomes of a novel metaphyseal porous titanium cone in revision total knee arthroplasty.

Shichman I, Anil U, van Hellemondt G, Gupta S, Willems J, Deshmukh A J Clin Orthop Trauma. 2024; 46:102282.

PMID: 38196965 PMC: 10772252. DOI: 10.1016/j.jcot.2023.102282.

Usefulness of Trabecular Metal Cones in Revision Total Knee Arthroplasty in a Korean Population: A Case Series.

Baek J, Lee S, Ryu S, Ahn H, Nam C Orthop Res Rev. 2022; 14:199-206.

PMID: 35707697 PMC: 9191581. DOI: 10.2147/ORR.S365377.

Management of bone loss in revision total knee arthroplasty: therapeutic options and results.

Rodriguez-Merchan E, Gomez-Cardero P, Encinas-Ullan C EFORT Open Rev. 2021; 6(11):1073-1086.

PMID: 34909226 PMC: 8631235. DOI: 10.1302/2058-5241.6.210007.

Design of Porous Metal Block Augmentation to Treat Tibial Bone Defects in Total Knee Arthroplasty Based on Topology Optimization.

Liu Y, Chen B, Wang C, Chen H, Zhang A, Yin W Front Bioeng Biotechnol. 2021; 9:765438.

PMID: 34820364 PMC: 8606634. DOI: 10.3389/fbioe.2021.765438.

Midterm Outcomes of Tantalum Metal Cones for Severe Bone Loss in Complex Primary and Revision Total Knee Arthroplasty.

Rajgopal A, Kumar S, Aggarwal K Arthroplast Today. 2021; 7:76-83.

PMID: 33521201 PMC: 7818605. DOI: 10.1016/j.artd.2020.12.004.

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