Structural allografting in revision total knee arthroplasty

While morsellized cancellous autograft or allograft have been shown to be highly successful in the management of smaller cavitary defects in revision TKA, structural allografts are often required for large, noncontained osseous defects. Early clinical results of revision TKA utilizing structural allografts have been encouraging with high allograft-host union rates if adequate allograft fixation is obtained. The use of intramedullary stems engaging diaphyseal bone is recommended to lessen load transmission to the structural allograft and the risk of late allograft collapse. Extensive preoperative planning, meticulous operative technique, and an extended period of postoperative rehabilitation are required for optimal results.