Published in:
01-05-2015 | Editorial
Revision total knee arthroplasty: the end of the allograft era?
Authors:
Sébastien Parratte, Matthew P. Abdel, Alexandre Lunebourg, Nicolaas Budhiparama, David G. Lewallen, Arlen D. Hanssen, Jean-Noël Argenson
Published in:
European Journal of Orthopaedic Surgery & Traumatology
|
Issue 4/2015
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Excerpt
Total knee arthroplasty (TKA) is highly successful, with an exponential increase expected in the near future [
1,
2]. More importantly, a fivefold increase in the number of revision TKAs is expected by 2030 [
1,
2]. In the latest studies, the top seven reasons for revision TKA include aseptic loosening (23.1 %), infection (18.4 %), polyethylene wear (18.1 %), instability (17.7 %), pain/stiffness (9.3 %), osteolysis (4.5 %), and malposition/misalignment (2.9 %) [
1,
3]. With modern implants, constraint can be effectively managed [
4]. However, one of the remaining challenges in revision TKA is the management of severe bone loss [
4]. Traditionally, allografts have been widely utilized to manage bone loss, with a significant failure rate at only mid-term follow-up [
4]. New techniques with restoration of the metaphysis have been developed to optimize the results of revision TKA [
4‐
8]. In this editorial, it was our aim to present contemporary management solutions for severe bone loss encountered at the time of revision TKA. …