Structural Allografts for Bone Loss in the Knee - Arthroplasty Options

Abstract

Bone loss around the knee in the setting of total knee arthroplasty remains a difficult and challenging problem for Orthopaedic surgeons. There are a number of options for dealing with smaller and contained bone loss, however segmental bone loss has fewer options. Small, contained defects may be treated with cement, morsellized autograft/allograft or metal augments. Larger amounts of bone loss or segmental bone loss cannot be dealt with by simple addition of cement, morselized autograft/allograft or metal augments. For younger or higher demand patients, the use of allograft is a good option as it provides a durable construct with high rates of union while restoring bone stock for future revisions. Older patients, or those who are low demand, may be better candidates for a tumour prosthesis, which provides immediate ability to weight-bear and mobilize.