Managing bone defects in primary total knee arthroplasty: options and current trends

Area of Science:

• Orthopaedic Surgery
• Biomaterials Science

Background:

• Bone deficiencies pose significant challenges in primary total knee arthroplasty.
• Effective management is crucial for successful implant integration and patient function.

Purpose of the Study:

• To review and discuss current management options for bone deficiencies in primary total knee arthroplasty.
• To explore evolving concepts and recent trends in treating these defects.

Main Methods:

• Evaluation of relevant literature focusing on treatment modalities for bone defects.
• Analysis of clinical and radiological outcomes and failure rates associated with different techniques.
• Discussion of the Anderson Orthopaedic Research Institute (AORI) system for bone defect classification.

Main Results:

• Multiple management options exist, including bone cement, bone grafting (autograft/allograft), metal augments, metaphyseal cones, and sleeves.
• The Anderson Orthopaedic Research Institute (AORI) system is the standard for classifying bone defects.
• No single treatment is universally applicable; each method has specific indications, advantages, and disadvantages.

Conclusions:

• Surgeons must possess comprehensive knowledge of available bone defect management options for total knee arthroplasty.
• Treatment selection should be tailored to the specific defect type and patient characteristics.
• Personalized management strategies are essential for optimizing outcomes in total knee arthroplasty with bone deficiencies.