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Bone loss following knee arthroplasty: potential treatment options

Archives of Orthopaedic and Trauma Surgery volume 134, pages 543–553 (2014)Cite this article

Abstract

Introduction

The management of bone loss is a crucial aspect of the revision knee arthroplasty. Bone loss can hinder the correct positioning and alignment of the prosthetic components, and can prevent the achievement of a stable bone–implant interface. There is still controversy regarding the optimal management of knee periprosthetic bone loss, especially in large defects for which structural grafts, metal or tantalum augments, tantalum cones, porous metaphyseal sleeves, and special prostheses have been advocated. The aim of this review was to analyze all possible causes of bone loss and the most advanced strategies for managing bony deficiency within the knee joint reconstruction.

Materials and methods

Most significant and recent papers about the management of bone defects during revision knee arthroplasty were carefully analyzed and reviewed to report the most common causes of bone loss and the most effective strategies to manage them.

Results

Modular metal and tantalum augmentation showed to provide more stable and durable knee revisions compared to allografts, limited by complications such as graft failure, fracture and resorption. Moreover, modular augmentation may considerably shorten operative times with a potential decrease of complications, above all infection which has been frequently associated to the use of allografts.

Conclusions

Modular augmentation may significantly reduce the need for allografting, whose complications appear to limit the long-term success of knee revisions.

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Affiliations

  1. Department of Medicine and Science for Health, University of Molise, Via Francesco De Sanctis, Campobasso, Italy

    Michele Vasso, Simone Cerciello & Alfredo Schiavone Panni

  2. Department of Orthopedics and Trumatology, Versailles “Andrè Mignot” Hospital, Versailles Saint Quentin University, Rue de Versailles 177, Le Chesnay, France

    Philippe Beaufils

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  1. Michele Vasso
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  2. Philippe Beaufils
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  4. Alfredo Schiavone Panni
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Correspondence to Michele Vasso.

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Vasso, M., Beaufils, P., Cerciello, S. et al. Bone loss following knee arthroplasty: potential treatment options. Arch Orthop Trauma Surg 134, 543–553 (2014). https://doi.org/10.1007/s00402-014-1941-8

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  • DOI: https://doi.org/10.1007/s00402-014-1941-8

Keywords

  • Revision knee arthroplasty
  • Knee reconstruction
  • Bone loss
  • Augments
  • Tantalum
  • Allografts