Wheeless' Textbook of Orthopaedics
Wheeless' Textbook of Orthopaedics
C.R. Wheeless MD
URL
Massive allografts in salvage revisions of failed total knee arthroplasties.
Mnaymneh-W; Emerson-RH; Borja-F; Head-WC; Malinin-TIDepartment of Orthopaedics, University of Miami School of Medicine, FL 33101.
Clin-Orthop. 1990 Nov(260): 144-53
Ten patients with failed total knee arthroplasties and severe bone
loss were treated with massive whole distal femur and proximal tibial
allografts in combination with prosthetic implants. Fourteen
allografts were inserted either as invaginated or segmental grafts
and were rigidly fixed to the host bone. Clinically and
roentgenographically, 12 of 14 grafts (86%) seemed to have united to
the host bone. The average range of motion was 92 degrees. Five
patients developed complications; two of these involved the allograft
(nonunion and fracture) and two were caused by inadequate healing at
the ligament-allograft junction. One patient had a late infection.
With careful planning and improved surgical techniques, these
complications can be avoided. The massive allograft-prosthesis
composite techniques is a viable reconstructive alternative worthy of
further clinical trials.
Massive allografts in salvage revisions of failed total knee arthroplasties.
Mnaymneh-W; Emerson-RH; Borja-F; Head-WC; Malinin-TIDepartment of Orthopaedics, University of Miami School of Medicine, FL 33101.
Clin-Orthop. 1990 Nov(260): 144-53
Ten patients with failed total knee arthroplasties and severe bone
loss were treated with massive whole distal femur and proximal tibial
allografts in combination with prosthetic implants. Fourteen
allografts were inserted either as invaginated or segmental grafts
and were rigidly fixed to the host bone. Clinically and
roentgenographically, 12 of 14 grafts (86%) seemed to have united to
the host bone. The average range of motion was 92 degrees. Five
patients developed complications; two of these involved the allograft
(nonunion and fracture) and two were caused by inadequate healing at
the ligament-allograft junction. One patient had a late infection.
With careful planning and improved surgical techniques, these
complications can be avoided. The massive allograft-prosthesis
composite techniques is a viable reconstructive alternative worthy of
further clinical trials.