[Revision interventions in aseptic and infected loose knee endoprostheses]

From 1984 to 1988 20 revisions for aseptic or septic loosening of knee prosthesis were performed. In 12 case there was an aseptic- and in 8 cases a septic loosening of the prosthesis. Most revision surgery for loosening of knee replacement needs reconstruction of bone stock. In loosening of unconstrained knee prostheses (uni-, totalcondylar knees) it was possible to insert a total condylar knee for revision surgery. Partially gross deviations had to be corrected, but in all cases a good alignment and ligamentous stability were effected. In septic loosening we had good experience with the two stage procedure. We temporarily implanted a gentamycine-PMMA-Spacer to avoid soft tissue contracture and to inhibit fusion of the cancellous bone. Arthodesis after knee replacement is difficult to manage, because the sclerotic bone of the site the prosthesis doesn't easily fuse.