POSTER ABSTRACTS - ISAKOS

E-poster w/ Standard #558
Distal Femoral Allograft Reconstruction for
Massive Osteolytic Bone Loss in Revision Total
Knee Arthroplasty
Hari Prasad Bezwada, USA, Presenter
Drexel University College of Medicine,
Philadelphia, PA, USA
Background: Massive osteolytic bone loss in
revision total knee arthroplasty has been an
uncommon challenge. However, oxidized
polyethylene inserts in modular total knee
arthroplasties with poor tibial locking
mechanisms have been associated with
substantial osteolysis. In cases where the bone
loss is massive, the use of distal femoral allograft
may be necessary in the reconstruction. The
purpose of this study is to review the clinical and
radiographic results of distal femoral allografts
utilized in revision knee arthroplasty for massive
bone loss.
Methods: From 2001-2002, 9 knees in 8 patients
underwent revision of failed modular PFC® total
knees arthroplasties with distal femoral allografts
and long-stemmed revision implants for massive
osteolytic induced femoral bone loss. Bone
defects were classified according to the AORI
rating system for femoral and tibial bone defects.
Clinical and radiographic results were evaluated
with the Knee Society rating system. The mean
follow-up was 29 months (range, 24-36 months).
Results: All 9 knees were found to have Type-III
femoral bone defects and Type-I tibial defects
both by pre-operative radiographic evaluation and
intraoperatively. Radiographic graft incorporation
was demonstrated in all 9 knees. There were no
cases of loosening and the overall frontal plane
alignment was 5 degrees of valgus. The knee
society pain scores improved by an average of 25.4
points and the function scores improved by an
average of 23.3 points.
Conclusion: The outcomes of distal femoral
allografts in the reconstruction of massive
osteolytic bone loss associated with failed
modular PFC® total knees arthroplasties are
favorable. Moreover, this is a durable
reconstruction technique for massive femoral
bone defects encountered during revision total
knee arthroplasty.
Jeong Ho Roh, Suwon, Kyung-gi, KOREA,
Presenter
Cheng Zhe Jin, Suwon, Kyung gi, KOREA
Kyung Hun Song, Suwon, Kyung gi, KOREA
Ajou university hospital, Dept of Ortho surgery,
Suwon, KOREA
Purpose : The purpose was trying to clarify utility
of allogenous bone graft on open type high tibial
osteotomy, among the method of treatment of
osteoarthritis with genu varum deformity.
Materials and Methods : Working with ten
patients who have osteoarthritis with genu varum
deformity, performed the open type high tibial
osteotomy. and after transplanting allogenous
bone graft, fixed using L-shaped plate. Before and
after the operation, measured the degree of
correction of genu varum through radiography of
anterior and posterior of weigh load, understudied
degree of union by testing bone histology during
removal of implant, and evaluated functional
factor as well as improvement of patients using
Lysholm's knee score and HSS knee score.
Results : According to radiography of anterior and
posterior of weigh load, the average of varus angle
was 5.3±3.2 before operation, the average of
correction angle was 16.1±4.1 after operation and
the average of valgus angle was 10.7±4.3 . By
radiography of anterior and posterior of weigh
load and lateral taken during the continual
observation, complate bone union was seen and
the average of correction loss angle was 1.5±1.0
and it got result that bone histology of
transplanted part was composed of osteologic
tissue and ratio of live bone and dead bone was
3.3:1, which live bone was 76.7±8% by image
analyzer (Pro Plus? system) during the implant
removal. After 15.3 months, average period of
observation, Average of Lysholm's score and HSS
knee score were increased from 66.2±8.3 to
75.7±9.1 and from 55.2±9.0 to 79.0±7.5
respectively.
Conclusion : The method that using a
transplantation of allogenous bone graft on open
type high tibial osteotomy, can be a fine surgical
technique because it gains a perfect union, has an
inconsiderable loss of correction angle and
precision of correction angle, can be contribute to
the improvement of functional knee joint.
E-poster #559
Open Wedge High Tibial Osteotomy with
Allogenous Bone Graft
Byoung Hyun Min, Suwon, KOREA