Impaction bone grafting for tibial defects in knee replacement surgery. Results at two years.

2.50
Hdl Handle:
http://hdl.handle.net/11287/610435
Title:
Impaction bone grafting for tibial defects in knee replacement surgery. Results at two years.
Authors:
Naim, Soulat; Toms, Andrew D
Abstract:
Bone loss with large defects poses a complex and challenging problem in primary and revision knee arthroplasty. The defects are often irregular and difficult to quantify. One of the techniques available to restore bone in such cases is Knee Impaction Bone Grafting (KIBG); however, the clinical literature to support this technique is weak. Since 2006 we have used impaction bone grafting for contained and uncontained large tibial defects in primary and revision total knee arthroplasty. We have prospectively studied 11 patients with large tibial defects treated at the Exeter Knee Reconstruction Unit with KIBG using a short cemented stem following the Slooff-Ling philosophy. Average age was 66 years (41-86 years). Minimum follow-up was 2 years. The Knee Society Scores improved from 27.4 to 89.2 on average, with Knee Society Function score and WOMAC increasing by 263 and 23.2 points respectively. The mean post-operative flexion was 112 degrees. The average gain in motion over preoperative value was 20 degrees. At two years there were no mechanical failures. None of the patients have required secondary procedures or further revisions. All radiographs showed incorporation and remodelling of the graft. The only complication was a superficial dysaesthesia around the operative scar. Although being time consuming and technically demanding, KIBG for substantial tibial bone loss has shown excellent versatility and good short term results, providing a stable construct with immediate weight bearing post operatively. In view of previous concerns regarding early incorporation and stability of impaction bone grafting in the tibia, we present our early results at 2 years. This technique has become our preferred technique for treating substantial bone loss in tibial defects seen in primary and revision knee arthroplasty surgery.
Citation:
Impaction bone grafting for tibial defects in knee replacement surgery. Results at two years. 2013, 79 (2):205-10 Acta Orthop Belg
Publisher:
Acta orthopaedica Belgica
Journal:
Acta orthopaedica Belgica
Issue Date:
Apr-2013
URI:
http://hdl.handle.net/11287/610435
PubMed ID:
23821973
Additional Links:
http://www.actaorthopaedica.be/acta/article.asp?lang=en&navid=243&id=15377&mod=acta
Note:
This article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text from the publisher's site.
Type:
Journal Article
Language:
en
ISSN:
0001-6462
Appears in Collections:
Exeter Knee Reconstruction Unit (EKRU); pre-2014 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorNaim, Soulaten
dc.contributor.authorToms, Andrew Den
dc.date.accessioned2016-05-20T11:27:21Zen
dc.date.available2016-05-20T11:27:21Zen
dc.date.issued2013-04en
dc.identifier.citationImpaction bone grafting for tibial defects in knee replacement surgery. Results at two years. 2013, 79 (2):205-10 Acta Orthop Belgen
dc.identifier.issn0001-6462en
dc.identifier.pmid23821973en
dc.identifier.urihttp://hdl.handle.net/11287/610435en
dc.description.abstractBone loss with large defects poses a complex and challenging problem in primary and revision knee arthroplasty. The defects are often irregular and difficult to quantify. One of the techniques available to restore bone in such cases is Knee Impaction Bone Grafting (KIBG); however, the clinical literature to support this technique is weak. Since 2006 we have used impaction bone grafting for contained and uncontained large tibial defects in primary and revision total knee arthroplasty. We have prospectively studied 11 patients with large tibial defects treated at the Exeter Knee Reconstruction Unit with KIBG using a short cemented stem following the Slooff-Ling philosophy. Average age was 66 years (41-86 years). Minimum follow-up was 2 years. The Knee Society Scores improved from 27.4 to 89.2 on average, with Knee Society Function score and WOMAC increasing by 263 and 23.2 points respectively. The mean post-operative flexion was 112 degrees. The average gain in motion over preoperative value was 20 degrees. At two years there were no mechanical failures. None of the patients have required secondary procedures or further revisions. All radiographs showed incorporation and remodelling of the graft. The only complication was a superficial dysaesthesia around the operative scar. Although being time consuming and technically demanding, KIBG for substantial tibial bone loss has shown excellent versatility and good short term results, providing a stable construct with immediate weight bearing post operatively. In view of previous concerns regarding early incorporation and stability of impaction bone grafting in the tibia, we present our early results at 2 years. This technique has become our preferred technique for treating substantial bone loss in tibial defects seen in primary and revision knee arthroplasty surgery.en
dc.language.isoenen
dc.publisherActa orthopaedica Belgicaen
dc.relation.urlhttp://www.actaorthopaedica.be/acta/article.asp?lang=en&navid=243&id=15377&mod=actaen
dc.rightsArchived with thanks to Acta orthopaedica Belgicaen
dc.subjectWessex Classification Subject Headings::Surgeryen
dc.subjectWessex Classification Subject Headings::Orthopaedicsen
dc.titleImpaction bone grafting for tibial defects in knee replacement surgery. Results at two years.en
dc.typeJournal Articleen
dc.identifier.journalActa orthopaedica Belgicaen
dc.description.noteThis article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text from the publisher's site.en
dc.type.versionPublisheden

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