BONE ALLOGRAFTING IN REVISION KNEE ARTHROPLASTY: HISTOLOGICAL CHARACTERISTICS OF STRUCTURAL ALLOGRAFTS 54 MONTHS FOLLOW UP

Cover Page


Cite item

Full Text

Abstract

Compensation of large bone defects by AORI third type classification is the most difficult problem the audit knee arthroplasty. In this situation, the surgeon have to choose between three possibilities: to use metal cones/sleeves, and, in cases with severely damaged metaepiphysis, to use structural allografts or oncological megaimplants. No doubt, it is interesting to follow the processes that are taking place with massive structural allografts implanted into the human body long time ago. This article presents the case study of the rheumatoid arthritis patient’s treatment with a severe lesion of the knee joint, subjected to repeated revision surgeries, last two of which are made with the use of massive structural allograft of femur. Morphological study of a massive distal femur allograft in 54 months after surgery showed that superficial ingrowth of connective tissue and blood vessels happens on the allograft’s border with its partial restructuring of the bone tissue at the border with the recipient bone. However, the most of allograft remains unchanged even after 54 months after surgery.

About the authors

T. A. Kuliaba

Vreden Russian Research Institute of Traumatology and Orthopedics
8, ul. Akad. Baykova, St. Petersburg, 195427, Russia

Author for correspondence.
Email: dr.Bovkis@mail.ru
Dr. Sci. (Med) Head of Knee Pathology Department Россия

N. N. Kornilov

Vreden Russian Research Institute of Traumatology and Orthopedics
8, ul. Akad. Baykova, St. Petersburg, 195427, Russia
Mechnikov North-Western State Medical University
41, Kirochnaya ul., St. Petersburg, 191015, Russia

Email: dr.Bovkis@mail.ru
Dr. Sci. (Med) Professor of Chair of Traumatology and Orthopaedics, Vreden Russian Research Institute of Traumatology and Orthopaedics; Associate Professor of Department of Traumatology and Orthopaedics of Mechnikov North-Western State Medical University Россия

G. Y. Bovkis

Vreden Russian Research Institute of Traumatology and Orthopedics
8, ul. Akad. Baykova, St. Petersburg, 195427, Russia

Email: dr.Bovkis@mail.ru
Researcher of Knee Pathology Department Россия

I. I. Croitoru

Vreden Russian Research Institute of Traumatology and Orthopedics
8, ul. Akad. Baykova, St. Petersburg, 195427, Russia

Email: dr.Bovkis@mail.ru
Cand. Sci. (Med) Researcher of Knee Pathology Department Россия

V. P. Rumakin

Vreden Russian Research Institute of Traumatology and Orthopedics
8, ul. Akad. Baykova, St. Petersburg, 195427, Russia

Email: dr.Bovkis@mail.ru
Cand. Sci. (Med) the Head of Autopsy Department Россия

References

  1. Бовкис Г.Ю., Куляба Т.А., Корнилов Н.Н. Компенсация дефектов метаэпифизов бедренной и большеберцовой костей при ревизионном эндопротезировании коленного сустава – способы и результаты их применения (обзор литературы). Травматология и ортопедия России. 2016;22(2):101-113.
  2. Корнилов Н.Н., Куляба Т.А., Филь А.С., Муравьёва Ю.В. Данные регистра эндопротезирования коленного сустава РНИИТО им Р.Р. Вредена за 2011-2013 годы. Травматология и ортопедия России. 2015;1(75):136-151.
  3. Куляба Т.А., Корнилов Н.Н. Ревизионная артропластика коленного сустава. СПб.: РНИИТО им. Вредена; 2016. 192 с.
  4. Куляба Т.А., Корнилов Н.Н., Селин А.В., Разорёнов В.Л., Кроитору И.И., Петухов А.И., Каземирский А.В., Засульский Ф.Ю., Игнатенко В.Л., Сараев А.В. Способы компенсации костных дефектов при ревизионном эндопротезировании коленного сустава. Травматология и ортопедия России. 2011;(3):5-12.
  5. Мурылев В., Холодаев М., Елизаров П., Рубин Г., Музыченков А. Опыт применения в травматологии онкопротезов коленного сустава при обширных околосуставных костных дефектах. Врач. 2015;1:64-68.
  6. Beckmann N.A., Mueller S., Gondan M., Jaeger S., Reiner T., Bitsch R.G. Treatment of severe bone defects during revision total knee arthroplasty with structural allografts and porous metal cones – a systematic review. J Arthroplasty. 2015;30(2):249-253. doi: 10.1016/j.arth.2014.09.016.
  7. Engh G.A., Herzwurm P.J., Parks N.L. Treatment of major defects of bone with bulk allografts and stemmed components during total knee arthroplasty. J Bone Joint Surg Am. 1997;79:1030-1039.
  8. Gioe T.J., Killeen K.K., Grimm K. Why are total knee replacements revised? Analysis of early revision in a community knee implant registry. Clin Orthop. 2004;428:100-106.
  9. Hamer A.J., Suvarna S.K., Stokley I. Histologic evidence of cortical allograft bone incorporation in revicion hip surgery. J Arthroplasty. 1997;12(7):785-789.
  10. Huff T.W., Sculco T.P. Management of bone loss in revision total knee arthroplasty. J Arthroplasty. 2007;22(7 Suppl 3): 32-36. doi: 10.1016/j.arth.2007.05.022.
  11. Kurtz S., Ong K., Lau E., Mowat F., Halpern M. Projections of primary and revision knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Аm. 2007;89(4);780-785. doi: 10.2106/JBJS.F.00222.
  12. Lotke P.A., Carolan G.F., Puri N. Impaction grafting for bone defects in revision total knee arthroplasty. Clin Orthop Relat Res. 2006;446:99-103. doi: 10.1097/01.blo.0000214414.06464.00.
  13. Mahomed N.N., Barret J., Katz J.N., Baron J.A., Wright J., Losina E. Epidimiology of total knee replacement in the United States Medicare population. J Bone Joint Surg Am. 2005;87(6);1222-1228. doi: 10.2106/JBJS.D.02546.
  14. Panni A.S., Vasso M., Cerciello S. Modular augmentation in revision total knee arthroplasty. Knee Surg Sports Trauml Arthrosc. 2013;21(12):2837-2843. doi: 10.1007/s00167-012-2258-1.
  15. Patel J.V., Masonis J.L., Guerin J. et al. The fate of augments to treat type-2 bone defects in revision knee arthroplasty. J Bone Joint Surg Br. 2004;86 195-199.
  16. Qiu Y.Y., Yan C.H., Chiu K.Y., Ng F.Y. Treatment for bone loss in revision total knee arthroplasty. J Orthop Surg (Hong Kong). 2012;20(1):78-86.
  17. Radnay C.S., Scuderi G.R. Management of bone loss: augments, cones, offset stems. Clin Orthop Relat Res. 2006; 446:83-92. doi: 10.1097/01.blo.0000214437.57151.41.
  18. Schmitz H.C., Klauser W., Citak M., Al-Khateeb H., Gehrke T., Kendoff D. Three-year follow up utilizing tantal cones in revision total knee arthroplasty. J Arthroplasty. 2013;28(9): 1556-1560. doi: 10.1016/j.arth.2013.01.028
  19. Ullmark G., Obrant K.J. Histology of impacted bone-graft incorporation. J Arthroplasty. 2002;17(2):150-157.
  20. van Loon C.J., Buma P., de Waal Malefijt M.C., van Kampen A., Veth R.P. Morselized bone allografting in revision total knee replacement – a case report with a 4-year histological follow-up. Acta Orthop Scand. 2000; 71(1):98-101. doi: 10.1080/00016470052943991.
  21. Whiteside L.A., Bicalho P.S. Radiologic and histologic analysis of morthellized allograft in revision total knee replacement. Clin Orthop Relat Res. 1998;357:149-156.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2016



СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies