Revision total knee arthroplasty: clinical outcome comparison with and without the use of femoral head structural allograft.
ABSTRACT The use of femoral head structural allograft (FHSA) for the management of massive bony defects during revision total knee arthroplasty (TKA) is well documented in the literature. The purpose of this study was to compare the clinical outcomes of patients undergoing revision (TKA) with FHSA to those without. All patients undergoing revision TKA between January 2000 and August 2005 were reviewed. Two cohorts were generated: a study cohort--revision TKA using FHSA (n = 24)--and control cohort--revision TKA without FHSA (n = 48). The 2 study cohorts groups were comparable. All patients completed validated outcome questionnaires. The FHSA cohort was found to have significantly better outcome scores. This study demonstrates improved clinical outcomes for patients undergoing revision TKA using a structural allograft compared with those without.
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ABSTRACT: Bone loss around the knee in the setting of total knee arthroplasty remains a difficult and challenging problem for orthopaedic surgeons. There are a number of options for dealing with smaller and contained bone loss; however, massive segmental bone loss has fewer options. Small, contained defects can be treated with cement, morselized autograft/allograft or metal augments. Segmental bone loss cannot be dealt with through simple addition of cement, morselized autograft/allograft, or metal augments. For younger or higher demand patients, the use of allograft is a good option as it provides a durable construct with high rates of union while restoring bone stock for future revisions. Older patients, or those who are low demand, may be better candidates for a tumour prosthesis, which provides immediate ability to weight bear and mobilize.Advances in orthopedics. 01/2011; 2011:578952.