Performing total knee replacement in cases with various degrees of bone loss

Keywords: bone defects, knee joint, arthroplasty, surgical treatment

Abstract

The paper analyses main factors that effect treatment results of total knee arthroplasties in cases of bone defects, such as a size and types of bone defects, their connection with previous surgeries, existing classification with their benefits and weak points. Authors show various possibilities of surgical treatment of bone defects that can provide better stability for prosthetic devices. The importance of bone grafts is highlighted as their remodeling provides the base for implant stability in late period of outcome.

Author Biographies

V. A. Filipenko, SE «Sytenko Institute of Spine and Joint Pathology National Academy of Medical Science of Ukraine», Department the Joints Pathology, Kharkiv

Filipenko Volodymyr A. - MD, PhD (Med), Professor

Department the Joints Pathology,

Sytenko Institute of Spine and Joint Pathology

80 Pushkinskaya Str., 61024, Kharkiv, Ukraine

+38 (057) 725-14-68

filippenko1957@gmail.com

https://orcid.org/0000-0001-5698-2726

O.V. Tankut, SE «Sytenko Institute of Spine and Joint Pathology National Academy of Medical Science of Ukraine», Department the Joints Pathology, Kharkiv

Tankut Oleksii V. - MD, PhD (Med), Associate Professor

Chief of Surgical Care,

Sytenko Institute of Spine and Joint Pathology

80 Pushkinskaya Str., 61024, Kharkiv, Ukraine

+38 (057) 725-14-00

tankutmed@gmail.com

https://orcid.org/0000-0002-9543-5327

O. G. Dudko, Higher State Educational Establishment of Ukraine «Bukovinian State Mediсal University», Department of Traumatology and Orthopedics, Chernivtsi

Dudko Oleksii G. - MD, PhD (Med), Associate Professor

Department of Traumatology and Orthopedics,

Bukovinian State Mediсal University,

2 Teatralna Sq., 58000, Chernivtsi City, Ukraine

+38 (0372) 55-37-54

Dudko.oleksii@bsmu.edu.ua

https://orcid.org/0000-0003-1848-5053

O. G. Shayko-Shaykovskiy, Yuriy Fedkovych Chernivtsi National University, Department of General Physics, Chernivtsi

Shayko-Shaykovskiy Olexander G. - DSci(Tech)

Professor of General Physics Department

Yuriy Fedkovych Chernivtsi National University,

 2 Kotsyubynsky Street, 58012, Chernivtsi City, Ukraine

+38 (0372) 58-48-89

shayko@bk.ru

https://orcid.org/0000-0002-0818-5367

References

1. Kurtz SM, Ong KL, Lau E, Widmer M, Maravic M, Gómez-Barrena E, et al. International survey of primary and revision total knee replacement. Int Orthop. 2011 Dec; 35(12), 1783-9. doi:10.1007/s00264-011-1235-5.
2. Kallala RE, Vanhegan IS, Ibrahim IS, Sarmah S, Haddad ES. Financial analysis of revision knee surgery based on NHS tariffs and hospital costs: does it pay to provide a revision service? Bone Joint J. 2015 Feb;97-B(2): 197-201. doi: 10.1302/0301-620X.97B2.33707.
3. Baldini A, Castellani L, Traverso F, Balatri A, Balato G, Franceschini V. The difficult primary total knee arthroplasty. A review. Bone Joint J. 2015 Oct;97-B (Suppl A):30-9. doi: 10.1302/0301-620X.97B10.36920.
4. Toms AD, Barker RI, McClelland D, Chua L, Spencer-Jones R, Kuiper J-H. Repair of defects and containment in revision total knee replacement. J Bone Joint Surgery. 2009 Feb;91-B:271-7. doi: 10.1302/0301-620X.91B2.21415.
5. Mulhall KJ, Gbanrawi HM, Engh GA, Clark CR, Lotke P, Saleh KJ. Radiographic prediction of intraoperative bone loss in knee arthroplasty revision. Clin Orthop Relat Res. 2006 May;446:51-8. doi:10.1097/01.blo.0000214438.57151.a.
6. Miura H, Matsuda S, Okazaki K, Kawano T, Kawamura H, Iwamoto Y. Validity of an oblique posterior condylar radiographic view for revision total knee arthroplasty. J. Bone Joint Surg Br. 2005 Dec 1;97-B:1643-6. doi:10.1302/0301-620x.87b12.16616.
7. Lucas K, Nolte I, Galindo-Zamora V, Lerch M, Stukenborg-Colsman C, Behrens BA, et al. Comparative measurements of bone mineral density and bone contrast values in canine femora using dual-energy X-ray absorptiometry and conventional digital radiography. BMC Veterinary Research. 2017 May;13(1):130. doi: 10.1186/s12917-017-1047-y.
8. Chun KJ. Bone Densitometry. Seminars in Nuclear Medicine. 2011 May;41(3):220-8. doi: 10.1053/j.semnuclmed.2010.12.002.
9. Yi Yan Qiu, Chun Hoi Yan, Kwong Yuen Chiu, Fu Yuen Ng. Review article: Bone defect classifications in revision total knee arthroplasty. J Orthop Surg. 2011 Aug;19 (2):238-43. doi:10.1177/230949901101900223.
10. Hoeffel DP, Rubash HE. Revision total knee arthroplasty: current rationale and techniques for femoral component revision. Clin Orthop Relat Res. 2000 Nov;(380):116-32. PMID: 11064981.
11. Huff TW, Sculco TP Management of bone loss in revision total knee arthroplasty. J Arthroplasty, 2007 Oct;22(7 Suppl 3):S32-7. doi:10.1016/j.arth.2007.05.022.
12. Mullhall KJ, Ghomrami HM, Engh GA, Clark CR, Lotke P, Saleh KJ. Radiographic prediction of intraoperative bone loss in knee arthroplasty revision. Clin Orthop Relat Res. 2006 May;446:51-8. doi:10.1097/01.blo.0000214438.57151.a5.
13. Engh GA, Ammeen DJ. Bone loss with revision total knee arthroplasty defect classification and alternatives for reconstruction. Instr Course Lect. 1999;48:167-75. PMID: 10098042.
14. Morgan-Jones R, Oussedik SI, Graichen H, Haddad FS. Zonal fixation in revision total knee arthroplasty. Bone Joint J. 2015 Feb;97-B(2):147-9. doi: 10.1302/0301-620X.97B2.34144.
15. Toms AD, Barker RL, Jones RS, Kuiper JH. Impaction bone-grafting in revision joint replacement surgery. J Bone Joint Surg Am. 2004 Sep;86-A(9):2050-60. PMID: 15342772.
16. Van Loon CJM, de Waal Malefijt MC, Buma P, Stolk PWTh, Verdonschot N, Tromp AM, et al. Autologous morsellised bone grafting restores uncontained femoral bone defects in knee arthroplasty. J Bone Joint Surg Br. 2000 Apr 1;82(3):436-44. doi: 10.1302/0301-620X.82B3.0820436.
17. Partington PE, Sawhney J, Parabeck CH, Barrack RL, Moore J. Joint line restoration after revision total knee arthroplasty. Clin Orthop Relat Res. 1999 Oct;(367):165-71. doi:10.1097/00003086-199910000-00020.
18. Chen F, Krackew KA. Management of tibial defects in total knee arthroplasty: a biomechanical study. Clin Orthop Relat Res. 1994 August;305(305):249-57. doi:10.1097/00003086-199408000-00031.
19. Lee JK, Choi CH. Management of tibial bone defects with metal augmentation in primary total knee replacement. J Bone Joint Surg Br. 2011 Nov;93(11):1493-6. doi:10.1302/0301-620x.93b11.27136.
20. Rand JA. Augmentation of a total knee arthroplasty with a modular metal wedge. A case report. J Bone Joint Surg Am. 1995 Feb;77(2):266-8. PMID: 7844134.
21. Brooks PJ, Walker PS, Scott RD. Tibial component fixation in deficient tibial bone stock. Clin Orthop Relat Res. 1984 Apr;184:302-8. doi:10.1097/00003086-198404000-00049.
22. Sculco PK, Abdel MP, Hanssen AD, Lewallen DG. The management of bone loss in revision total knee arthroplasty: rebuild, reinforce, and augment. Bone Joint J. 2016 Jan;98-B(1 Suppl A):120-4. doi: 10.1302/0301-620X.98B1.36345.
23. Patel JV, Masonis JI, Guerin J, Bourne RB, Rorabeck CH. The fate of augments to treat type-2 bone defects in revision knee arthroplasty. J Bone Joint Surg Br. 2004Mar;86(2):195-9. doi:10.1302/0301-620x.86b2.13564.
24. Toms AD, Barker RL, McClelland D, Chua L, Spencer-Jones R, Kuiper J-H. Repair of defects and containment in revision total knee replacement. A comparative biomechanical analysis. J Bone Joint Surg Br. 2009 Feb;91(2):221-7. doi:10.1302/0301-620x.91b2.21415.
25. Mumith A, Coathup M, Chimutengwede-Gordon M, Aston W, Briggs T, Blunn G. Augmenting the osseointegration of endoprostheses using laser-sintered porous collars. Bone Joint J. 2017 Feb;99-B(2):276-82. doi:10.1302/0301-620x.99b2.bjj-2016-0584.r1.
26. Wittaker JK, Dharmarajan R, Toms AD. The management of bone loss in revision total knee replacement. J Bone Joint Surg Br. 2008 Aug;90(8):981-7. doi:10.1302/0301-620x.90b8.19948.
27. Wang JW, Hsu CH, Huang CC, Lin PC, Chen WS. Reconstruction using femoral head allograft in revision total knee replacement. An experience in Asian patients. Bone Joint J. 2013 May;95-B(5):643-8. doi:10.1302/0301-620x.95b5.29915.
28. Jeffery RS, Orton MA, Denham RA. Wedged tibial components for total knee arthroplasty. J Arthroplasty. 1994 Aug;9(4):381-7. doi: 10.1016/0883-5403(94)90048.
29. Akca K, Eser A, Cavusoglu Y, Sagirkaya E, Cehreli MC. Numerical assessment of bone remodeling around conventionally and early loaded titanium and titanium-zirconium alloy dental implants. Med Biol Eng Comput. 2015 May;53(5):453-62. doi: 10.1007/s11517-015-1256-0.
30. Hoerth RM, Katunar MR, Sanchez AG, Orellano JC, Cere SM, Wagermaier W, et al. A comparative study of zirconium and titanium implants in rat: osseointegration and bone material quality. J Mater Sci Mater Med. 2014 Feb;25(2):411-22. doi: 10.1007/s10856-013-5074-3.
31. Willis-Owen CA, Keene GC, Oakeshott RD. Early metallosis-related failure after total knee replacement. J Bone Joint Surg Br. 2011 Feb;93(2): 205-9. doi:10.1302/0301-620x.93b2.25150.
32. Dudko OG, Storoschuk IV, Pickula VV, Strashok YuV, Ribak MI, Alkamel SM, et al. The long term follow-up of internal fracture fixation with metal versus polymeric fixation devices. Clinical anatomy and operative surgery. 2017;16(1):115-6. doi: 10.24061/1727-0847.16.1.2017.25. [In Ukrainian].
Published
2019-01-30
Section
General Problems of Surgery