1. Metaphyseal cones combined with diaphyseal impaction grafting provide good outcomes and survival in a complex revision total knee arthroplasty: a matched comparative analysis.
- Author
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Dzidzishvili, Lika, Sáez, David, and Calvo, Emilio
- Subjects
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KNEE joint , *PROSTHESIS-related infections , *TOTAL knee replacement , *RETROSPECTIVE studies , *SURGICAL complications , *ARTIFICIAL joints , *TREATMENT effectiveness , *COMPARATIVE studies , *REOPERATION , *TIBIA , *PROSTHESIS design & construction , *BONE grafting , *COMPLICATIONS of prosthesis - Abstract
Purpose: To compare clinical and radiological outcomes, implant survivorship at a minimum of 1-year follow-up using metaphyseal trabecular cones with or without impaction grafting in a complex revision TKA. Methods: A retrospective comparative matched analysis was performed and 15 patients who underwent revision surgery using the combination of porous trabecular metaphyseal cone and diaphyseal impaction grafting (MC–IBG) were matched with a group of 13 patients who also underwent revision surgery using metaphyseal cone (MC) without impaction grafting. All included patients presented severe bone defect (AORI 2,3) and a rotating-hinge prosthesis were implanted. Results: Both groups were comparable regarding the baseline demographic and clinical data. Patients had previously undergone a mean of 4 (range, 2–12) and 3 (range, 2–5) previous procedures in the MC-IBG and MC groups, respectively. The indications for revision were aseptic loosening in 11 (73.3%) and 11 (84.6%) patients; prosthetic joint infection in 4 (26.7%) and 2 (15.4%) in the MC–IBG and MC groups, respectively. There was no significant difference in the mean postoperative Knee Society Score between the study groups (p = 0.806). Overall, 4 patients had further revision. Two patients were revised in the MC–IBG group, one patient for aseptic loosening and the second one after 2 episodes of instability. Two patients in the MC group presented prosthetic joint infection and underwent a two-stage reimplantation. No significant difference was observed between the study groups at comparison (p = 0.92). Conclusion: Trabecular metal cones with diaphyseal impaction grafting provide an alternative technique in a complex revision TKA surgery with early clinical and radiographic success. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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