Allograft in revision total knee arthroplasty

Abstract

Some degree of bone loss is present in every failed total knee arthroplasty. In most instances, bone loss is minor and adequate bone stock is available to support primary components. However, certain failure modes lead to more severe bone loss that may affect the structural integrity of revision components. Management of this type of bone loss and the accompanying soft tissue asymmetry is the most challenging aspect of revision total knee arthroplasty.Augmentation with cement, bone graft, and modular or custom components may be needed. Cement is adequate in smaller defects and has been used in larger defects with screws.1,2 Cement has poor biomechanical properties; therefore, as defects increase in size or complexity, other solutions are necessary. Graft offers intraoperative flexibility and relatively low cost when compared with customs. Autograft is preferred; however, it is usually in short supply in the revision setting. Therefore, allograft is relied on commonly in these situations. Despite its widespread use, good clinical studies are sparse. In this chapter, we delineate the indications and results of allograft in revision total knee arthroplasty. © 2005 Springer Science+Business Media, Inc. All rights reserved.