Abstract
In total knee arthroplasty (TKA), a treatment of bone defect varies depending on the location and extent of defect and requires proper surgical procedure. Metal augmentation is readily available for both femoral and tibial bone defects. We report the operative technique of modular metal augmentation using a downsized block for ambiguous proximal tibial and distal femoral bone defects in primary and revision TKA. Regarding bone defects, bone loss can be minimized by using a different size of metal augmentation, and suitable reinforcement for bone defects can be achieved. Once our technique is properly used, it will be very helpful in treating bone defects.
Highlights
Bone defects during either primary or revision total knee arthroplasty (TKA) represent a substantial challenge to correct alignment of implants and establishment of a stable bone-implant interface
In TKA, bone defects may occur due to several factors, including iatrogenic implant and cement removal, stress shielding, mechanical loosening, osteolysis, and infection [1]-[7]
We report the operative technique of modular metal augmentation using a downsized block for ambiguous proximal tibial and distal femoral bone defects in revision TKA
Summary
Bone defects during either primary or revision total knee arthroplasty (TKA) represent a substantial challenge to correct alignment of implants and establishment of a stable bone-implant interface. In TKA, bone defects may occur due to several factors, including iatrogenic implant and cement removal, stress shielding, mechanical loosening, osteolysis, and infection [1]-[7]. Treatments of severe bone defects include structural allograft, modular metal augmentation with a wedge or a block, metaphyseal tantalum cones or sleeves, or custom implant [8]-[10]. Modular metal augmentation has high availability and familiarity but limitations in size and shape at massive asymmetric uncontained tibial bone defects. Choi introduced double rectangular metal blocks augmentation for managing severe uncontained bone defects [11]. There has been no evidence demonstrating treatment of bone defects with modular metal augmentation using various sized blocks.
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