Advertisement for orthosearch.org.uk
Orthopaedic Proceedings Logo

Receive monthly Table of Contents alerts from Orthopaedic Proceedings

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

Visit Orthopaedic Proceedings at:

Loading...

Loading...

Full Access

General Orthopaedics

Treatment of Periprosthetic Osteolysis Using Trabecular Metal in Revision Knee Arthroplasty

The International Society for Technology in Arthroplasty (ISTA)



Abstract

Introduction

Several options exist for the treatment of periprosthetic osteolysis in revision knee surgery. We describe our preliminary short-term experiences using trabecular metal (TM) technology in order to fill bony defects either on the femoral or on the tibial side.

Material and Methods

52 revision knee surgeries in which this TM technology had been used were retrospectively reviewed clinically and radiographically. Indication for revision included 51 cases with aseptic loosening of Total Knee Arthroplasty. In one case of periprostheti infection, a staged revision procedure was performed. Assessment of bone loss included the AORI classification (1989) and was performed pre- and intraoperatively. Clinical evaluation was performed using the HSS score. In 6 cases in addition to usng the TM cones, an impaction grafting technique was performed.

Results

Average follow up was 22 months. So far, not loosening of a TM cone neither clinically nor radiographically was observed. In 74% of the cases, either a type FII-TII-FIII or TIII defect was seen. Average number of pre-existing surgeries was 4,6. Pre-operative Range of motion was 0-84 degrees and 0-98 degrees at time of latest follow up. Complications in this series included 2 periprosthetic fractures and 1 periprosthetic infection, later revised to a successful fusion. Upon explantation of the TM cone in this case, stable osteointegration was observed. HSS score increased from 34 to 62 points postoperatively (49-93).

Discussion

Treatment of severe periprosthetic osteolysis in our eyes can be managed successfully in the short-term range using TM technology which requires a meticulous surgical technique and proper indication. This material might be successfully combined using homologous bone as an adjunct.


Email: