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Cementless revision total knee arthroplasty

L A Whiteside1

  • 1DePaul Biomechanical Research Laboratory, Missouri Bone and Joint Center, St. Louis 63044.

Clinical Orthopaedics and Related Research
|January 1, 1993
PubMed
Summary
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Cementless revision total knee arthroplasty (TKA) with bone grafting effectively reconstructs bone defects and achieves durable implant fixation. This technique improves knee alignment, stability, and patient comfort, offering encouraging outcomes for complex cases.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Radiology

Background:

  • Revision total knee arthroplasty (TKA) presents challenges due to significant bone loss.
  • Maintaining implant stability and restoring bone stock are critical for successful revision TKA.

Purpose of the Study:

  • To report the outcomes of cementless revision TKA using a specific bone grafting technique.
  • To describe the method for managing massive femoral and tibial bone defects in revision TKA.

Main Methods:

  • Fifty-six cementless revision TKAs were performed using long-stemmed components and morselized allograft.
  • Implants were rigidly fixed using the remaining bone shell and diaphysis, with screw augmentation.
  • Bone grafting addressed major femoral and tibial bone stock deficiencies.

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Main Results:

  • At two years post-surgery, 54% of patients reported no pain, and 30% reported mild pain.
  • Radiodensity in grafted areas increased one and two years postoperatively, indicating bone healing.
  • 54 out of 56 implants achieved stable fixation, with improvements in alignment, stability, and comfort.

Conclusions:

  • Cementless revision TKA with bone grafting is an effective technique for reconstructing bone defects.
  • The described method provides durable short-term fixation and improves functional outcomes.
  • This approach offers encouraging results for patients with severe bone loss undergoing revision knee surgery.