Impaction bone grafting for the reconstruction of large bone defects in revision knee arthroplasty
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| 024 | 7 | 0 | |a 10.1007/s00064-014-0330-3 |2 doi |
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| 245 | 0 | 0 | |a Impaction bone grafting for the reconstruction of large bone defects in revision knee arthroplasty |h [Elektronische Daten] |c [M. Rudert, B.M. Holzapfel, E. von Rottkay, D.E. Holzapfel, U. Noeth] |
| 246 | 1 | |a Impaction-Bone-Grafting zur Rekonstruktion ausgedehnter Knochendefekte beim Knieprothesenwechsel | |
| 520 | 3 | |a Objective: Regeneration of autologous bone stock and formation of a stable implant bed by impaction of morselized bone allograft. Indications: Bone loss after septic and aseptic loosening or tumour resection. Contraindications: Persistent infection, one-stage septic revision, poor therapeutic compliance, extensive uncontained metaphyseal defects with cortical thinning of the diaphysis. Surgical technique: Whilst the surgeon removes the loose prosthesis, the assistant prepares the graft. The medullary canal is sealed with a cement restrictor. Graft particles of different sizes are densely impacted around a trial stem. The highest level of stability is achieved by using large particles interspersed with small filler particles. Low-viscosity cement facilitates cement penetration and ensures strong interdigitation with the impacted graft mass after implantation of the prosthesis. Uncontained metaphyseal defects are treated with prosthetic augments. Postoperative management: Gait training, physiotherapy with isometric quadriceps exercises, partial weight-bearing for 6weeks, resistance training begins 8weeks postoperatively. Results: Between 2010 and 2012, 28patients with large bone defects [Anderson Orthopaedic Research Institute (AORI) grade: 21 × F3, 3 × F2, 13 × T3, 8 × T2] underwent total knee revision with impaction bone grafting. The mean follow-up was 27.7months (range 21-47months). On average, patients had undergone 2.5previous revisions. Implant survival was 82.0 % (95 % CI = 62.5 %-92.1 %) for any reason of revision as the endpoint and 93.1 % (95 % CI = 74.5-98.4 %) for aseptic revision as the endpoint. The mean postoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was 35.4 (range 3.3-101.6, SD ± 26.2). The mean KSS was 70.6 (range 20-100, SD ± 26.8). | |
| 540 | |a Springer-Verlag Berlin Heidelberg, 2015 | ||
| 690 | 7 | |a Bone defects |2 nationallicence | |
| 690 | 7 | |a Impaction |2 nationallicence | |
| 690 | 7 | |a Bone grafting |2 nationallicence | |
| 690 | 7 | |a Allograft |2 nationallicence | |
| 690 | 7 | |a Reconstruction |2 nationallicence | |
| 690 | 7 | |a Knochendefekte |2 nationallicence | |
| 690 | 7 | |a Impaktion |2 nationallicence | |
| 690 | 7 | |a Knochentransplantation |2 nationallicence | |
| 690 | 7 | |a Allotransplantat |2 nationallicence | |
| 690 | 7 | |a Rekonstruktion |2 nationallicence | |
| 700 | 1 | |a Rudert |D M. |u Department of Orthopaedic Surgery, University of Wuerzburg, Koenig-Ludwig-Haus, Brettreichstr. 11, 97072, Wuerzburg, Germany |4 aut | |
| 700 | 1 | |a Holzapfel |D B.M. |u Department of Orthopaedic Surgery, University of Wuerzburg, Koenig-Ludwig-Haus, Brettreichstr. 11, 97072, Wuerzburg, Germany |4 aut | |
| 700 | 1 | |a von Rottkay |D E. |u Department of Orthopaedic Surgery, University of Wuerzburg, Koenig-Ludwig-Haus, Brettreichstr. 11, 97072, Wuerzburg, Germany |4 aut | |
| 700 | 1 | |a Holzapfel |D D.E. |u Department of Trauma Surgery, University Hospital Munich, Campus Innenstadt, Ludwig-Maximilians University, Munich, Germany |4 aut | |
| 700 | 1 | |a Noeth |D U. |u Department for Orthopaedics and Trauma Surgery, Evangelisches Waldkrankenhaus Spandau, Berlin, Germany |4 aut | |
| 773 | 0 | |t Operative Orthopädie und Traumatologie |d Springer Berlin Heidelberg |g 27/1(2015-02-01), 35-46 |x 0934-6694 |q 27:1<35 |1 2015 |2 27 |o 64 | |
| 856 | 4 | 0 | |u https://doi.org/10.1007/s00064-014-0330-3 |q text/html |z Onlinezugriff via DOI |
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| 900 | 7 | |a Metadata rights reserved |b Springer special CC-BY-NC licence |2 nationallicence | |
| 908 | |D 1 |a research-article |2 jats | ||
| 949 | |B NATIONALLICENCE |F NATIONALLICENCE |b NL-springer | ||
| 950 | |B NATIONALLICENCE |P 856 |E 40 |u https://doi.org/10.1007/s00064-014-0330-3 |q text/html |z Onlinezugriff via DOI | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Rudert |D M. |u Department of Orthopaedic Surgery, University of Wuerzburg, Koenig-Ludwig-Haus, Brettreichstr. 11, 97072, Wuerzburg, Germany |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Holzapfel |D B.M. |u Department of Orthopaedic Surgery, University of Wuerzburg, Koenig-Ludwig-Haus, Brettreichstr. 11, 97072, Wuerzburg, Germany |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a von Rottkay |D E. |u Department of Orthopaedic Surgery, University of Wuerzburg, Koenig-Ludwig-Haus, Brettreichstr. 11, 97072, Wuerzburg, Germany |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Holzapfel |D D.E. |u Department of Trauma Surgery, University Hospital Munich, Campus Innenstadt, Ludwig-Maximilians University, Munich, Germany |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Noeth |D U. |u Department for Orthopaedics and Trauma Surgery, Evangelisches Waldkrankenhaus Spandau, Berlin, Germany |4 aut | ||
| 950 | |B NATIONALLICENCE |P 773 |E 0- |t Operative Orthopädie und Traumatologie |d Springer Berlin Heidelberg |g 27/1(2015-02-01), 35-46 |x 0934-6694 |q 27:1<35 |1 2015 |2 27 |o 64 | ||