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Early Outcomes of Patient-Specific Modular Cones for Substitution of Methaphysial and Diaphysial Bone Defects in Revision Knee Arthroplasty
- Authors: Cherny A.A.1, Kovalenko A.N.1, Bilyk S.S.1, Denisov A.O.1, Kazemirskiy A.V.1, Kulyaba T.A.1, Kornilov N.N.1
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Affiliations:
- Vreden Russian Research Institute of Traumatology and Orthopedics
- Issue: Vol 25, No 2 (2019)
- Pages: 9-18
- Section: Clinical studies
- Submitted: 14.07.2019
- Accepted: 14.07.2019
- Published: 14.07.2019
- URL: https://journal.rniito.org/jour/article/view/1209
- DOI: https://doi.org/10.21823/2311-2905-2019-25-2-9-18
- ID: 1209
Cite item
Abstract
The aim of this study was the assessment of early outcomes of patient-specific three-dimensional titanium cones with specified porosity parameters to compensate for extensive metaphysical-diaphyseal bone defects in RTKA.
Materials and Methods. Since 2017 till 2019 30 patient-specific titanium cones (12 femoral and 18 tibial) implanted during 26 RTKAS. Clinical outcomes evaluated using KSS, WOMAC and fjS-12 scoring systems on average 10 (2–18) months after surgery. At the same time the stability of implant fixation analyzed using frontal, lateral and axial knee roentgenograms.
Results. During all procedures there were no technical difficulties in positioning and implantation of custom-made titanium cones. At the time of preparation of the publication, none of the patients had indications for further surgical intervention, as well as intra- and postoperative complications. Six months after surgery all scores improved significantly: KSS from 23 (2–42, SD 19.96) to 66.5 (62–78, SD 7.68), WOMAC from 59 (56–96, SD 28.31) to 32.25 (19–46, SD 11.76), the index FJS-12 was 29.16 points (0–68.75, SD 30.19). The average scores continued to improve up to 18 months: KSS — 97.5 (88–108, SD 9.14), WOMAC — 16.5 (9–24, SD 6.45), FJS-12 — 45.85 (25–75, SD 22.03). No radiolucent lines were noticed during this period of observation.
Conclusion. The original additive technology of designing and producing patient-specific titanium cones for compensation of extensive metaphyseal-diaphyseal bone defects in RTKA is a valid solution at least in the short term. A longer follow-up period is required to assess its medium-and long-term reliability compared to existing alternative surgical solutions.
About the authors
A. A. Cherny
Vreden Russian Research Institute of Traumatology and Orthopedics
Author for correspondence.
Email: alexander.cherny.spb@gmail.com
Alexander A. Cherny — orthopaedic surgeon
St. Petersburg
РоссияA. N. Kovalenko
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Anton N. Kovalenko — cand. Sci. (Med.), researcher, Department of Diagnosis of Diseases and Injuries of the Musculoskeletal System
St. Petersburg
РоссияS. S. Bilyk
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Stanislav S. Bilyk — laboratory assistant-researcher, Department of Diagnosis of Diseases and Injuries of the Musculoskeletal System
St. Petersburg
РоссияA. O. Denisov
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Aleksey O. Denisov — cand. Sci. (Med.), academic secretary
St. Petersburg
РоссияA. V. Kazemirskiy
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Alexander V. Kazemirskiy — cand. Sci. (Med.), senior researcher, Knee Pathology Department
St. Petersburg
РоссияT. A. Kulyaba
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Taras A. Kulyaba — Dr. Sci. (Med.), head of the Knee Pathology Department
St. Petersburg
РоссияN. N. Kornilov
Vreden Russian Research Institute of Traumatology and Orthopedics
Email: fake@neicon.ru
Nikolai N. Kornilov — Dr. Sci. (Med.), professor, chair of Traumatology and orthopedics; leading researcher, Knee Pathology Department
St. Petersburg
РоссияReferences
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