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Reconstruction using femoral head allograft in revision total knee replacement: An experience in Asian patients.
MedLine Citation:
PMID:  23632674     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Structural allografts may be used to manage uncontained bone defects in revision total knee replacement (TKR). However, the availability of cadaver grafts is limited in some areas of Asia. The aim of this study was to evaluate the mid-term outcome of the use of femoral head allografts for the reconstruction of uncontained defects in revision TKR, focusing on complications related to the graft. We retrospectively reviewed 28 patients (30 TKRs) with Anderson Orthopaedic Research Institute (AORI) type 3 bone defects, who underwent revision using femoral head allografts and stemmed components. The mean number of femoral heads used was 1.7 (1 to 3). The allograft-host junctions were packed with cancellous autograft. At a mean follow-up of 76 months (38 to 136) the mean American Knee Society knee score improved from 37.2 (17 to 60) pre-operatively to 90 (83 to 100) (p < 0.001). The mean function score improved from 26.5 (0 to 50) pre-operatively to 81 (60 to 100) (p < 0.001). All the grafts healed to the host bone. The mean time to healing of the graft was 6.6 months (4 to 16). There have been no complications of collapse of the graft, nonunion, infection or implant loosening. No revision surgery was required. The use of femoral head allografts in conjunction with a stemmed component and autogenous bone graft in revision TKR in patients with uncontained bone defects resulted in a high rate of healing of the graft with minimal complications and a satisfactory outcome. Longer follow-up is needed to observe the evolution of the graft. Cite this article: Bone Joint J 2013;95-B:643-8.
Authors:
J-W Wang; C-H Hsu; C-C Huang; P-C Lin; W-S Chen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The bone & joint journal     Volume:  95-B     ISSN:  2049-4408     ISO Abbreviation:  Bone Joint J     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101599229     Medline TA:  Bone Joint J     Country:  England    
Other Details:
Languages:  eng     Pagination:  643-8     Citation Subset:  AIM; IM    
Affiliation:
Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, 123, Ta Pei Road, Niao Sung Dist, Kaohsiung City, Taiwan.
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