Contemporary bone loss options: Rebuild, reinforce, and augment

Peter K. Sculco, Matthew Abdel

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Bone loss is commonly encountered during revision total knee arthroplasty (TKA). Small defects can be adequately managed with cement filling (with or without screws), modular prosthetic augments, and morselized allograft. For larger defects, cancellous impaction grafting and structural allografts have traditionally been utilized. More recently, highly porous tantalum cones and titanium sleeves have been designed to achieve axial and rotational stability in the metaphysis and subsequent biologic fixation. Sleeves are linked to one type of prosthesis, whereas cones are unlinked and can be used with any implant design. Multiple studies have demonstrated excellent survivorship and radiographic osseointegration at mid-term follow-up. This article provides a review of contemporary methods of bone loss management with a focus on highly porous metals and an emphasis on the authors' preferred method for managing the severe bone loss in revision TKA.

Original languageEnglish (US)
Pages (from-to)108-111
Number of pages4
JournalSeminars in Arthroplasty
Volume26
Issue number2
DOIs
StatePublished - Jun 1 2015

Fingerprint

Knee Replacement Arthroplasties
Bone and Bones
Allografts
Tantalum
Osseointegration
Titanium
Prostheses and Implants
Metals

Keywords

  • Highly porous metaphyseal cones
  • Impaction bone grafting
  • Metaphyseal sleeves
  • Revision total knee arthroplasty
  • Structural allograft
  • Tantalum

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Contemporary bone loss options : Rebuild, reinforce, and augment. / Sculco, Peter K.; Abdel, Matthew.

In: Seminars in Arthroplasty, Vol. 26, No. 2, 01.06.2015, p. 108-111.

Research output: Contribution to journalArticle

@article{5b3484db80bd44b59c4b42ebab658bb7,
title = "Contemporary bone loss options: Rebuild, reinforce, and augment",
abstract = "Bone loss is commonly encountered during revision total knee arthroplasty (TKA). Small defects can be adequately managed with cement filling (with or without screws), modular prosthetic augments, and morselized allograft. For larger defects, cancellous impaction grafting and structural allografts have traditionally been utilized. More recently, highly porous tantalum cones and titanium sleeves have been designed to achieve axial and rotational stability in the metaphysis and subsequent biologic fixation. Sleeves are linked to one type of prosthesis, whereas cones are unlinked and can be used with any implant design. Multiple studies have demonstrated excellent survivorship and radiographic osseointegration at mid-term follow-up. This article provides a review of contemporary methods of bone loss management with a focus on highly porous metals and an emphasis on the authors' preferred method for managing the severe bone loss in revision TKA.",
keywords = "Highly porous metaphyseal cones, Impaction bone grafting, Metaphyseal sleeves, Revision total knee arthroplasty, Structural allograft, Tantalum",
author = "Sculco, {Peter K.} and Matthew Abdel",
year = "2015",
month = "6",
day = "1",
doi = "10.1053/j.sart.2015.08.016",
language = "English (US)",
volume = "26",
pages = "108--111",
journal = "Seminars in Arthroplasty",
issn = "1045-4527",
publisher = "W.B. Saunders Ltd",
number = "2",

}

TY - JOUR

T1 - Contemporary bone loss options

T2 - Rebuild, reinforce, and augment

AU - Sculco, Peter K.

AU - Abdel, Matthew

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Bone loss is commonly encountered during revision total knee arthroplasty (TKA). Small defects can be adequately managed with cement filling (with or without screws), modular prosthetic augments, and morselized allograft. For larger defects, cancellous impaction grafting and structural allografts have traditionally been utilized. More recently, highly porous tantalum cones and titanium sleeves have been designed to achieve axial and rotational stability in the metaphysis and subsequent biologic fixation. Sleeves are linked to one type of prosthesis, whereas cones are unlinked and can be used with any implant design. Multiple studies have demonstrated excellent survivorship and radiographic osseointegration at mid-term follow-up. This article provides a review of contemporary methods of bone loss management with a focus on highly porous metals and an emphasis on the authors' preferred method for managing the severe bone loss in revision TKA.

AB - Bone loss is commonly encountered during revision total knee arthroplasty (TKA). Small defects can be adequately managed with cement filling (with or without screws), modular prosthetic augments, and morselized allograft. For larger defects, cancellous impaction grafting and structural allografts have traditionally been utilized. More recently, highly porous tantalum cones and titanium sleeves have been designed to achieve axial and rotational stability in the metaphysis and subsequent biologic fixation. Sleeves are linked to one type of prosthesis, whereas cones are unlinked and can be used with any implant design. Multiple studies have demonstrated excellent survivorship and radiographic osseointegration at mid-term follow-up. This article provides a review of contemporary methods of bone loss management with a focus on highly porous metals and an emphasis on the authors' preferred method for managing the severe bone loss in revision TKA.

KW - Highly porous metaphyseal cones

KW - Impaction bone grafting

KW - Metaphyseal sleeves

KW - Revision total knee arthroplasty

KW - Structural allograft

KW - Tantalum

UR - http://www.scopus.com/inward/record.url?scp=84949684123&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84949684123&partnerID=8YFLogxK

U2 - 10.1053/j.sart.2015.08.016

DO - 10.1053/j.sart.2015.08.016

M3 - Article

AN - SCOPUS:84949684123

VL - 26

SP - 108

EP - 111

JO - Seminars in Arthroplasty

JF - Seminars in Arthroplasty

SN - 1045-4527

IS - 2

ER -