title: The management of bone loss in revision total knee arthroplasty: rebuild, reinforce, and augment.
abstract: The treatment of bone loss in revision total knee arthroplasty has evolved over the past decade. While the management of small to moderate sized defects has demonstrated good results with a variety of traditional techniques (cement and screws, small metal augments, impaction bone grafting or modular stems), the treatment of severe defects continues to be problematic. The use of a structural allograft has declined in recent years due to an increased failure rate with long-term follow-up and with the introduction of highly porous metal augments that emphasise biological metaphyseal fixation. Recently published mid-term results on the use of tantalum cones in patients with severe bone loss has reaffirmed the success of this treatment strategy.
authors.affiliation: Mayo Clinic, 200 First Street S.W., Rochester, Minnesota, 55905, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Sculco
authors.affiliation: Mayo Clinic, 200 First Street S.W., Rochester, Minnesota, 55905, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Abdel
authors.affiliation: Mayo Clinic, 200 First Street S.W., Rochester, Minnesota, 55905, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Hanssen
authors.affiliation: Mayo Clinic, 200 First Street S.W., Rochester, Minnesota, 55905, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Lewallen
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D006801:Humans; D010014:Osteolysis / Q000145:classification / Q000209:etiology* / Q000601:surgery*; D012086:Reoperation
keywords: Revision total knee arthroplasty (TKA); Metaphyseal sleeves; Highly porous cones; Impaction bone grafting; Structural allograft