Comparative evaluation of the use of the double cementation method and modular metal augments for the replacement of bone defects in revision knee arthroplasty

Serik Sabirzhanovich Balgazarov,Aleksey Alexandrovich Belokobylov,Arman Nurlanuly Batpen,Aliya Mukhtarovna Atepileva,Aliya Mukhtarovna Atepileva,Yersultan Yernarovich Alzhanov,Denis Vladimirovich Rimashevskiy,Alexandr Alexandrovich Kriklivyy,Alexandr Alexandrovich Kriklivyy,Ruslan Sartaevich Abilov,Artyom Valerievich Moroshan,Zhanatay Kolbaevich Ramazanov,Alexey Alexeevich Dolgov

doi:10.23950/jcmk/14682

Abstract

Background: During revision arthroplasty of the knee joint, defects of the femur and tibia may occur. One common method to replace these defects is the use of modular metal augments, but this method has certain disadvantages. Therefore, we suggest using the double cementation method. Objective: This study aims to compare the effectiveness of the double cementation method and modular metal augments in replacing bone defects during revision knee replacement. Material and Methods: We examined 150 patients diagnosed with periprosthetic infection who were treated at the National Scientific Center of Traumatology and Orthopedics named after Academician N.D.Batpenov from 2021 to 2024. For a randomized study, 36 patients were selected, divided into 2 groups of 18 people. In the main group, the double cementing method was used to replace defects of the femur and tibia during revision knee arthroplasty; in the control group, metal augments were used. A follow-up examination was conducted on all patients one year after the surgery. Results: No significant differences were found between the groups in terms of the number of hospital beds spent (p = 0.11), bed days spent in the intensive care unit after surgery (p = 0.44), duration of surgery (p = 0.18), amount of intraoperative blood loss (p = 0.18), knee joint function according to the Knee Society Score (p = 0.23) and Oxford Knee Score (p = 0.09). In the main group, signs of radiographic instability were detected in 1 case (5.6%), in the control group, there were revealed 5 (27.8%) cases. The number of cases of periprosthetic infection in the main group was 1 case (5.6%), in the control group were 3 cases (16.7%). Conclusion: The double cementation method is less likely to cause radiography lines of illumination at the cement/bone boundary and may be recommended for high-risk postoperative infections. Additionally, it may be more cost-effective than using metal augments.

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