title: Bone loss following knee arthroplasty: potential treatment options.
abstract: BACKGROUND
  The management of bone loss is a crucial aspect of the revision knee arthroplasty. Bone loss can hinder the correct positioning and alignment of the prosthetic components, and can prevent the achievement of a stable bone-implant interface. There is still controversy regarding the optimal management of knee periprosthetic bone loss, especially in large defects for which structural grafts, metal or tantalum augments, tantalum cones, porous metaphyseal sleeves, and special prostheses have been advocated. The aim of this review was to analyze all possible causes of bone loss and the most advanced strategies for managing bony deficiency within the knee joint reconstruction.
  
  
  METHODS
  Most significant and recent papers about the management of bone defects during revision knee arthroplasty were carefully analyzed and reviewed to report the most common causes of bone loss and the most effective strategies to manage them.
  
  
  RESULTS
  Modular metal and tantalum augmentation showed to provide more stable and durable knee revisions compared to allografts, limited by complications such as graft failure, fracture and resorption. Moreover, modular augmentation may considerably shorten operative times with a potential decrease of complications, above all infection which has been frequently associated to the use of allografts.
  
  
  CONCLUSIONS
  Modular augmentation may significantly reduce the need for allografting, whose complications appear to limit the long-term success of knee revisions.
authors: Department of Medicine and Science for Health, University of Molise, Via Francesco De Sanctis, Campobasso, Italy, vassomichele@gmail.com.
authors: Michele
authors: M
authors: Vasso
authors: Philippe
authors: P
authors: Beaufils
authors: Simone
authors: S
authors: Cerciello
authors: Alfredo
authors: A
authors: Schiavone Panni
mesh_terms: D064591:Allografts; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D001862:Bone Resorption / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007720:Knee Prosthesis; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D013635:Tantalum; D016896:Treatment Outcome
chemical_list: D013635:Tantalum