Outcome of Revision Total Knee Arthroplasty with Bone Allograft in 30 Cases

Revision Total Knee Arthroplasty is often complicated by large bone defects in the distal femur and proximal tibia. These defects can be managed in a variety of ways including the use of allograft bone. The purpose of this study was to retrospectively evaluate the clinical outcome of revision total knee arthroplasty cases where allograft bone was used. Thirty revision TKA's (27 patients) performed between 1994 and 2009 were followed for a mean of 5 years (1-14 years). Preoperative bone defects were classified using the Anderson Orthopaedic Research Institute classification system. Patient follow-up entailed calculation of the Knee Society Score and radiological assessment of the revision joint replacement in addition to review of complications. Kaplan Meier analysis predicted survivorship at 5 years as 93%, with further revision surgery as end point. The average Knee Society Score was 76.4, with 19 (63%) of knees scoring "excellent" results, 4 (14%) "good", 1 (3%) "fair" and 6 (20%) were "poor". The overall complication rate was 233%. Radiological lucency was demonstrated on recent radiographs for one patient. Three knees were re-revised at 1 year, 6 years and 8 years respectively. Our study demonstrates promising short to medium term results with the use of allograft bone in revision total knee replacement presenting with significant bone loss.