Morselized bone grafting in revision arthroplasty of the knee: a retrospective analysis of 34 reconstructions after 2-9 years.
OBJECTIVE
Loosening of a total knee replacement may lead to loss of bone, requiring biological reconstruction at revision arthroplasty. Good results have been reported from revision arthroplasty of the hip using impaction bone grafting. We report our results of revision total knee arthroplasty using the same technique.


METHODS
We retrospectively analyzed 30 patients (involving 34 knees) with a mean age of 63 (34-81) years who, between 1994 and 2002, underwent revision arthroplasty of the knee using hinge or rotational knee prostheses (Link) and impaction bone grafting. The average follow-up was 4 (2-9) years and included a questionnaire, a clinical examination, and standardized radiographs.


RESULTS
25 patients were satisfied with their results. 10 patients reported no impairment in their activities of daily living attributed to their operation and did not need any walking support. In 5 patients, there were no clear radiographic signs of incorporation of the graft but that did not compromise the outcome. 5 other patients had complications due to aseptic loosening of their prostheses with radiographic failure of the graft, leading to a periprosthetic fracture in 2 cases.


CONCLUSIONS
Our results with impaction bone grafting in knee revision arthroplasty appear to be similar to those obtained by the same technique in revision hip surgery.
Auguste Viktoria Klinik, Bad Oeynhausen, Hamburg, Germany. wsteens@gmx.de
Wolfram
W
Steens
Jochen F
JF
Loehr
Joachim
J
Wodtke
Alexander
A
Katzer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods; D016025:Bone Transplantation / Q000379:methods; D005260:Female; D005270:Femur Head / Q000637:transplantation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome