title: Novel Technique: Knee Arthrodesis Using Trabecular Metal Cones with Intramedullary Nailing and Intramedullary Autograft.
abstract: The failed total knee arthroplasty is a challenge to the surgeon and the patient. Infection, bone loss, and instability lead to a chronically painful and dysfunctional limb. Two-stage revision arthroplasty has been successful in clearing a majority of periprosthetic joint infections. However, there are many cases when the multiply revised and infected total knee arthroplasty cannot be salvaged. We report, a review of knee arthrodesis and a novel technique to manage significant bone loss. The use of trabecular metal cones and a long intramedullary nail can be used in concert with an autologous intramedullary bone graft to provide a stable, length restoring construct with sufficient biology to heal very large bone voids. With this technique we have successfully restored function and stability in the failed knee arthroplasty.
authors.affiliation: Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri.
authors.forename: Blake E
authors.initials: BE
authors.lastname: Peterson
authors.affiliation: Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri.
authors.forename: Sonny
authors.initials: S
authors.lastname: Bal
authors.affiliation: Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri.
authors.forename: Ajay
authors.initials: A
authors.lastname: Aggarwal
authors.affiliation: Department of Orthopaedic Trauma, University of Missouri, Columbia, Missouri.
authors.forename: Brett D
authors.initials: BD
authors.lastname: Crist
mesh_terms: D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D064592:Autografts; D001858:Bone Nails; D001862:Bone Resorption / Q000209:etiology / Q000601:surgery; D016025:Bone Transplantation; D002908:Chronic Disease; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008670:Metals; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology / Q000601:surgery; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D012086:Reoperation; D016879:Salvage Therapy; D014182:Transplantation, Autologous
chemical_list: D008670:Metals