scholarly journals Review Article: Bone Defect Classifications in Revision Total Knee Arthroplasty

2011 ◽  
Vol 19 (2) ◽  
pp. 238-243 ◽  
Author(s):  
Yi Yan Qiu ◽  
Chun Hoi Yan ◽  
Kwong Yuen Chiu ◽  
Fu Yuen Ng
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Defect ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Review Article ◽  
Total Knee

Comparative Analysis between Cone and Sleeve in Managing Severe Bone Defect during Revision Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 31 (07) ◽  
pp. 677-685 ◽  
Author(s):  
Hyun Jung Kim ◽  
O-Sung Lee ◽  
Seung Hoon Lee ◽  
Yong Seuk Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Defect ◽  
Knee Arthroplasty ◽  
Statistical Significance ◽  
Radiolucent Line ◽  
Clinical Score ◽  
Revision Total Knee Arthroplasty ◽  
Quality Data ◽  
Radiological Outcome ◽  
Total Knee

AbstractThis review aims to compare the outcomes of revision total knee arthroplasty (TKA) performed using a tantalum cone and a titanium sleeve. A rigorous and systematic search was performed. Each of the selected studies was evaluated for methodological quality. Data were extracted according to the following: study design, level of evidence, cases enrolled, age, sex ratio, follow-up, involved part, bone defect, degree of constraint, augments (cone and/or sleeve), pre-clinical score, post-clinical score, radiological results, major complications, and endpoint analysis. Nineteen articles were included in the final analysis. The knee scores of the cone and sleeve groups were increased in all studies with or without statistical significance. For the radiological outcome, radiolucent line was seen in six cases in the cone group and in 15 cases in the sleeve group. Only a few specific augment-related complications were noted. Our results support the use of the newly devised augments in bone defect during revision TKA in terms of clinical and radiological outcome.

scholarly journals Review Article: Treatments for Bone Loss in Revision Total Knee Arthroplasty

2012 ◽  
Vol 20 (1) ◽  
pp. 78-86 ◽  
Author(s):  
Yi Yan Qiu ◽  
Chun Hoi Yan ◽  
Kwong Yuen Chiu ◽  
Fu Yuen Ng
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Loss ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Review Article ◽  
Total Knee

scholarly journals Are Metaphyseal Sleeves a Viable Option to Treat Bone Defect during Revision Total Knee Arthroplasty? A Systematic Review

Joints ◽  
2019 ◽  
Vol 07 (01) ◽  
pp. 019-024 ◽  
Author(s):  
Tommaso Bonanzinga ◽  
Ibrahim Akkawi ◽  
Akos Zahar ◽  
Thorsten Gehrke ◽  
Carl Haasper ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Clinical Outcome ◽  
Bone Defect ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Septic Loosening ◽  
Total Knee ◽  
Revision Tka

Abstract Purpose Bone loss is a challenging problem during revision total knee arthroplasty (TKA). Several studies have been published on the use of metaphyseal sleeves during revision TKA. Therefore, the aim of this systematic review was to summarize the clinical and radiographic outcomes of the use of metaphyseal sleeves in the setting of revision TKA. Methods A comprehensive search of PubMed, MEDLINE, CINAHL, Cochrane, EMBASE, and Google Scholar was performed, covering the period between January 1, 2000, and August 12, 2017. Various combinations of the following key words were used: “metaphyseal,” “sleeves,” “knee,” and “revision.” A total of 10 studies were included in the present systematic review. Results A total of 904 patients with 928 implants were recorded with a mean age of 69 years. They were evaluated at a mean follow-up of 45 months. Overall 1,413 sleeves, 888 in the tibia and 525 in the femur, were implanted. There were 36 septic re-revisions of the prosthetic components (4%). Five sleeves were found loose during septic re-revision; therefore, the rate of septic loosening of the sleeves was 0.35%. An aseptic re-revision of the prosthetic components was performed 27 times (3%). Ten sleeves were found loose during aseptic re-revision; therefore, the rate of aseptic loosening of the sleeves was 0.7%. Intraoperative fractures occurred 44 times (3.1%). Finally, clinical outcome was improved at final follow-up. Conclusion Metaphyseal sleeves demonstrate high radiographic signs of osteointegration, low septic loosening rate, low intraoperative fractures rate, and a good-to-excellent clinical outcome. Hence, they are a valid option to treat large metaphyseal bone defect during revision TKA. Level of Evidence This is a systematic review of level IV studies.

scholarly journals Suitability of Metal Block Augmentation for Large Uncontained Bone Defect in Revision Total Knee Arthroplasty (TKA)

2019 ◽  
Vol 8 (3) ◽  
pp. 384 ◽  
Author(s):  
Kwan Kang ◽  
Trinh Tien ◽  
Myung Lee ◽  
Kwon-Yong Lee ◽  
Bongju Kim ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Cement ◽  
Bone Defect ◽  
Knee Arthroplasty ◽  
Strain Distribution ◽  
Stress Transfer ◽  
Bone Defects ◽  
Revision Total Knee Arthroplasty ◽  
Total Knee ◽  
Metal Block

This study was performed to determine whether metal block augmentation is suitable for large uncontained bone defect via evaluations of differences in biomechanical characteristics among the configurations of metal block augmentations for medium or large uncontained bone defects in revision total knee arthroplasty (TKA). Three-dimensional finite element (FE) models of the proximal tibia with revision TKA were developed and analyzed considering the configurations of the metal block augmentations for medium and large uncontained bone defects. To identify differences in biomechanical characteristics according to the configurations of metal block augmentations, the stress transfer, strain distribution, and peak von Mises stresses (PVMSs) were assessed. Large and medium uncontained bone defects had similar ranges of strain below the critical bone-damage strain for the metal block augmentations, but the strain distribution characteristics differed in response to the metal block-augmentation configurations. PVMSs exceeding the yield strength of the bone cement for the single metal block-augmentation configurations were, on average, 1.4 times higher than those for double metal block-augmentation configurations for both medium and large uncontained bone defects. These findings suggest that metal block augmentation may be suitable for large uncontained bone defects (≤20 mm), compared with the results obtained for metal block augmentation used in medium uncontained bone defects (≤10 mm). If possible, double metal block augmentation is recommended for both medium and large uncontained bone defects rather than single metal block augmentation. It is also recommended that the metal block augmentation should be customized to meet the contact characteristics with the cortical bone, thereby ensuring better stress transfer and reducing the risk of the bone resorption due to stress shielding and bone-cement failure.

scholarly journals Outcomes of the rotating hinge knee in revision total knee arthroplasty with a median follow-up of 6.2 years

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jake von Hintze ◽  
Mika Niemeläinen ◽  
Harri Sintonen ◽  
Jyrki Nieminen ◽  
Antti Eskelinen
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Survival Rate ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Patient Reported ◽  
Total Knee ◽  
Revision Tka

Abstract Background The purpose of this study was to determine the mid-term clinical, radiographic and health-related quality of life (HRQoL) outcomes and define the survival rate in patients who had undergone revision total knee arthroplasty (TKA) using the single rotating hinged knee (RHK) design. Methods Between January 2004 and December 2013, 125 revision TKAs were performed at our institution using the single RHK implant. We conducted both a retrospective analysis of prospectively collected outcome data of these patients and a prospective follow-up study of all 39 living patients (41 knees). The follow-up phase included an optional extra follow-up visit, PROM questionnaires, and plain radiographs. Results The ten-year Kaplan-Meier survival rate of the revision RHK knees was 81.7% (95% CI 71.9–91.6%) with re-revision for any reason as the endpoint. Overall, 15 knees (12% of the total) underwent re-revision surgery during the follow-up. The median follow-up was 6.2 years (range, 0–12.7 years) post-operatively for the baseline group. One mechanical hinge mechanism-related failure occurred without any history of trauma or infection. At the time of the final follow-up, the majority of patients evinced a fairly good clinical outcome measured with patient-reported outcome measures and none of the components were radiographically loose. Conclusion We found that in patients undergoing complex revision TKA, fairly good functional outcome and quality of life can be achieved using an RHK implant. Further, it seems that in this type of patient cohort, revision TKA using an RHK implant relieves pain more than it improves ability to function. The NexGen® RHK design can be regarded as a suitable option in complex revision TKA.

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