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Modular augmentation in revision total knee arthroplasty.

Alfredo Schiavone Panni¹, Michele Vasso, Simone Cerciello

¹Department of Science for Health, University of Molise, Via Francesco De Sanctis, Campobasso, Italy, a.schiavone@iol.it.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA

|November 1, 2012

Summary

Modular augmentation effectively manages severe bone defects in revision total knee arthroplasty, improving patient outcomes and function. This technique offers good survivorship, potentially reducing the need for bone allografts.

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Area of Science:

Orthopedic Surgery
Biomaterials Science
Reconstructive Surgery

Background:

Bone defects in revision total knee arthroplasty present significant reconstructive challenges.
The effectiveness of modular augmentation for managing these defects remains a subject of debate.

Purpose of the Study:

To evaluate the effectiveness of modular augmentation in reconstructing severe bone defects during revision total knee arthroplasty.
To assess the impact on overall outcomes, incidence of radiolucency/osteolysis, and mid-term survivorship.

Main Methods:

A consecutive series of 38 revision knee arthroplasties utilizing modular augmentation (metal augments, tantalum cones, cementless stems) for Type 2 and 3 defects.
Median follow-up of 7 years, with assessments using IKS and HSS scores, and range of motion measurements.

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Main Results:

Significant improvements observed in IKS knee (34 to 78) and function (19.5 to 76) scores, and HSS scores (30 to 80.5) (p < 0.001).
Median knee flexion improved from 82° to 116° (p < 0.01).
Low rates of tibial radiolucency (5.2%) and re-revision (7.9%) were noted.

Conclusions:

Modular augmentation provides a viable solution for severe bone defects in revision total knee arthroplasty.
This technique leads to well-functioning and durable knee joint reconstructions.
It may decrease the reliance on bone allografting for complex cases.