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Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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[Bone defect management in revision knee arthroplasty].

Eric Röhner1,2, Markus Heinecke3, Georg Matziolis3

  • 1Deutsches Zentrum für Orthopädie, Waldkliniken Eisenberg, Klosterlausnitzer Straße 81, 07607, Eisenberg, Deutschland. e.roehner@waldkliniken-eisenberg.de.

Der Orthopade
|October 16, 2021
PubMed
Summary

Revision total knee arthroplasty (TKA) faces fixation challenges, especially with poor bone quality. This study evaluates techniques like cones and sleeves for stable implant anchoring in revision TKA to improve outcomes.

Keywords:
AllograftsBone cementProsthesis fixationRevision surgeryTotal knee replacement

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering
  • Medical Device Technology

Background:

  • In 2019, Germany performed 14,462 revision total knee arthroplasties (TKA), representing 11.6% of all TKAs.
  • Aseptic loosening is the primary reason for revision TKA (23.9%), often linked to fixation difficulties.
  • Insufficient bone quality compromises cementless or cemented diaphyseal anchoring in revision TKA.

Purpose of the Study:

  • To present and evaluate various techniques for stable anchoring of revision implants.
  • To compare the clinical and radiological outcomes of cones versus sleeves in bone defect management during revision knee arthroplasty.

Main Methods:

  • Review of current techniques for stable anchoring of revision implants.
  • Evaluation of cemented/cementless stem anchoring, bone allografts, wedges, blocks, cones, and sleeves.
  • Comparative analysis of cones and sleeves for bone defect management in revision TKA.

Main Results:

  • The study evaluates diverse methods for secure fixation of revision knee implants.
  • A comparison between cones and sleeves in managing bone defects during revision TKA is presented.
  • The findings will inform optimal strategies for implant fixation based on bone quality and defect size.

Conclusions:

  • Effective fixation is critical for the success of revision total knee arthroplasty.
  • Various implant anchoring techniques exist, including stems, grafts, and modular components like cones and sleeves.
  • Further research comparing specific techniques like cones and sleeves is needed to optimize revision TKA outcomes.