Abstract
Object: To determine whether moderate bone loss in revision total knee arthroplasty can be corrected using an uncemented prosthesis combined with cancellous bone grafting.
Methods and results: 23 revision total knee replacements for aseptic loosening or sepsis were undertaken by the senior author between May 1999 and August 2002. All cases involved bone loss of grades F2 and or T2 according to the Anderson Orthopaedic Research Institute Classification (Engh 1998). Bone loss was treated with a mixture of morselized autograft, morselized allograft and bone reamings loosely packed into any contained or uncontained defects following the technique of Whiteside (1992). Uncemented pros-theses with long contact bearing stems were then inserted.
All 23 cases were able to partially weight bear immediately postoperatively, indicating satisfactory early press fit. No cases of loosening or cases suspicious of loosening have been noted.
Of the 23 cases 19 have been followed for at least 1 year. 18/19 showed consolidation of bone defects and in 1 case there was significant bone resorption under the tibial base plate due to stress shielding.
Conclusion: This technique is successful in building up moderate bone loss in revision total knee arthroplasty, therefore avoiding the need for excessive bone resection, large metal augments, mass allografts or custom prostheses.
The abstracts were prepared by Mr Roger Smith. Correspondence should be addressed to him at the British Association for Surgery of the Knee, c/o BOA, Royal College of Surgeons of England, 35–43 Lincoln’s Inn Fields, London WC2A 3PN.
