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Complex total knee arthroplasty using resection prostheses at mid-term follow-up.

Ben Molenaers1, Nele Arnout, Johan Bellemans

  • 1Department of Orthopaedics and Traumatology, University Hospitals Leuven, Weligerveld 1, 3212 Pellenberg, Belgium. ben_molenaers@hotmail.com

The Knee
|October 11, 2011
PubMed
Summary

Resection prostheses offer acceptable outcomes for complex knee replacements with significant bone loss. However, these salvage knee reconstructions are associated with a relatively high complication rate.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering

Background:

  • Complex primary or revision total knee arthroplasty (TKA) often presents challenges due to major bone loss and soft tissue deficiencies.
  • Resection type prostheses are utilized in TKA to address these complex reconstructive needs.

Purpose of the Study:

  • To evaluate the clinical and radiographic outcomes of salvage knee reconstructions using the Finn/OSS knee system.
  • To assess the efficacy and complication rates of resection prostheses in complex primary and revision TKA.

Main Methods:

  • Retrospective study of 66 patients undergoing TKA with the Finn/OSS knee system.
  • Average follow-up of 5 years (range 2-12 years).
  • Indications included massive bone loss and/or soft tissue deficiency in 63 revision and 3 primary cases.

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Main Results:

  • Significant improvement in Knee Society Score (KSS) from 46 to 73 and function score from 27 to 47.
  • Implant survivorship was 92% at 5 and 10 years with revision as the endpoint.
  • Complications included 4 revisions (infection, aseptic loosening, implant breakage) and 9 minor reinterventions (wound drainage, patellar realignment, extensor mechanism repair). Two cases of peroneal nerve palsy occurred.

Conclusions:

  • Resection prostheses provide acceptable clinical and radiographic results for complex primary and revision TKA.
  • The use of these prostheses in salvage knee reconstructions is associated with a relatively high complication rate that requires careful consideration.