Abstract
Purpose of the study: The objective of this work was to analyze outcome in a series of patients with bone anomalies after failed knee arthroplasty who were treated in the same institution with revision prosthesis with use of fragmented and structured bone grafts.
Material and methods: Between April 1994 and June 2004, a total of 515 knee arthroplasties were performed at the Italian hospital of Buenos Aires. Among these, 27 were revisions after failure of a primary arthroplasty. Two patients (follow-up less than one year) were excluded from the analysis. Among the 25 patients analyzed, eight were men and 17 women, mean age 67 years (range 41–87). Minimum follow-up was one year, mean 3.5 years, range 3–9 years. The cause of primary arthoplasty failure was aseptic loosening for ten knees, prosthetic infection in eleven, and pain in three and periprosthetic fracture in one. Fragmented or structured allografts were used for reconstruction in 15 patients. Reconstruction concerned the femur or the tibia after removal of the primary prosthesis. For twelve patients, a fragmented allograft was impacted and for three a combined fragmented-structured allograft was used. For 21 reconstructions, the revision prosthesis had intramedul-lary femoral and tibial stems and for 15, complementary elements were added to the prosthetic components on the femoral piece for three, on the tibial piece for four and on both for eight.
Conclusion: Use of fragmented and structured allografts combined with complementary elements offers a valid alternative for reconstruction of bone stock loss after failed primary knee arthroplasty.
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