Bone defects substitution in total knee replacement (literature review)

Authors

  • Oleksii Tankut
  • Oleksii Dudko

DOI:

https://doi.org/10.15674/0030-59872019397-103

Keywords:

arthroplasty, knee joint, bone defects, bioinert materials

Abstract

The number of primary and revision total knee arthroplasties is continuously increasing. Presence of bone defects is one of the challenging issues for these surgeries that affects significantly treatment results and increases expenses.

Objective: to analyze methods of preoperative and intraoperative diagnostics of knee joint articulating surfaces bone defects and existing classifications according to their advantages and disadvantages, to substantiate the treatment strategy for cases with various types of bone defects.

Methods: articles from PubMed, EBSCO and Google Scholar data bases were used for scientific review.

Results: the main negative factors affecting the stability of prosthesis components are the size and the shape of bone defect, presence or absence of cortical layer, quality of bone tissue, as well as implant design and correct choice of material and technique for filling of the defect. Evaluation of materials of natural origin — different types of bone grafts and artificial augments made of metals and polymeric materials was performed. Methods of bone grafts preparation and their fixation are important for different types of bone defects. In more complicated cases individual guides and resection blocks, virtual prototyping technologies and 3D-printing should be used for individual manufacturing of endoprosthesis.

Conclusions: Usage of modern materials and techniques for filling of bone defects in total knee arthroplasties requires precise preoperative planing and choice of proper technique. Structural or morselized bone allografts, bone cement alone or in combination with screws and meshes, metal or polymeric augments of various shapes should be used for small bone defects, depending from their type, but large bone defects require stems and individually produced oncological and hinge implants. 

Author Biographies

Oleksii Tankut

Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

PhD in Traumatology and Orthopaedics

Oleksii Dudko

HSEE of Ukraine «Bukovinian State Medical University», Chernivtsi

MD, PhD in Traumatology and Orthopaedics

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How to Cite

Tankut, O., & Dudko, O. (2019). Bone defects substitution in total knee replacement (literature review). ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3), 97–103. https://doi.org/10.15674/0030-59872019397-103

Issue

No. 3 (2019)

Section

DIGESTS AND REVIEWS

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Copyright (c) 2019 Oleksii Tankut, Oleksii Dudko

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