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Bone Loss in Revision Total Knee Arthroplasty: Evaluation and Management
Neil P Sheth1, Marcelo Batista Bonadio, Marco Kawamura Demange
1From the Department of Orthopaedic Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA (Dr. Sheth), and the Department of Orthopaedic Surgery, Universidade de São Paulo, São Paulo, Brazil (Dr. Bonadio and Dr. Demange).
Abstract:
With the increasing number of total knee arthroplasty (TKA) procedures being performed annually, the burden of revision surgery is also expected to increase. Addressing bone loss during revision TKA is a considerable challenge that requires proper preoperative evaluation and surgical planning. In addition to an assessment of femoral and tibial bone loss, a systematic approach to the management of bone loss associated with TKA includes careful implant selection, adherence to the general principles of revision TKA, and an understanding of the available reconstruction options. These options include cement with screws, morcellized allograft, bulk structural allograft, modular wedges, block augments, porous metal cones or sleeves, and megaprostheses.