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[Mega-prostheses in revision knee arthroplasty].
D Rak1, M Weißenberger1, K Horas1
1Klinik König-Ludwig-Haus Würzburg, Lehrstuhl für Orthopädie, Universität Würzburg, Brettreichstraße 11, 97074, Würzburg, Deutschland.
Der Orthopade
|November 5, 2021
Summary
Revision total knee arthroplasty (TKA) is increasing, necessitating megaprostheses due to bone loss. Careful planning is crucial as megaprostheses carry risks of infection and loosening, often requiring salvage procedures.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
Background:
- Total knee arthroplasty (TKA) is predicted to increase, leading to a rise in revision TKA procedures.
- Decreasing patient age at TKA may increase the need for multiple revisions.
- Bone and soft tissue loss escalates with each revision, making megaprostheses essential.
Purpose of the Study:
- To highlight the growing importance of revision TKA.
- To underscore the necessity and challenges of using megaprostheses in revision TKA.
- To discuss complications associated with megaprostheses in revision TKA.
Main Methods:
- Review of current trends in TKA and revision TKA.
- Analysis of bone and soft tissue loss in revision scenarios.
- Examination of megaprosthesis implantation considerations and risks.
Main Results:
- Megaprostheses are becoming indispensable in revision TKA due to cumulative bone and soft tissue loss.
- Megaprosthesis implantation requires careful consideration due to increased risks of infection and loosening.
- Complications such as mechanical failure, patient-specific issues, and infections are common.
Conclusions:
- Revision TKA, particularly with megaprostheses, presents significant challenges.
- Careful planning and consideration of risks are paramount for successful megaprosthesis implantation.
- Salvage procedures like arthrodesis or amputation are often necessary for managing complications.
Keywords:
InfectionPeriprosthetic fracturesProsthesis looseningRevision surgeryTotal knee replacement
