CLASSIFICATION FOR KNEE JOINT BONES DEFECTS IN PATIENTS WITH CONTRINDICATIONS TO ARTHROPLASTY

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Abstract

There are many classifications of long bone defects. Some of them are designed from the external fixation background standpoint with the aim to define a particular Ilizarov technique. Another group of classifications is aimed at determining the tactics of reconstructive surgery for segmental defects of long bones. However, combinations of defects at articular ends are not considered. AORI classification (and the analogs) is intended to address issues related to arthroplasty and it does not consider diaphyseal defects.

The aim of the present study was to develop a functional classification for the knee joint bone defects (KJBD) for cases when there are contraindications to arthroplasty.

For this purpose the authors analyzed knee joint x-rays of 71 patients with KJBD and contraindications to arthroplasty. Defects extent, shape and anatomical localization in tibia and femur were evaluated.

Results. This allowed to identify 4 types of defects depending on the location and size. We determined four types of defects, depending on its location and severity: I — epiphyseal, II — epimetaphyseal, III — local epimetaphyophyseal, IV — extensive epimetaphyophyseal.

Conclusion. In contrast to other classifications the proposed one takes into consideration the combination of defects in femur and tibia when it is impossible to perform the arthroplasy and is designed to develop an algorithm for treating this group of patients.

About the authors

L. N. Solomin

Vreden Russian Research Institute of Traumatology and Orthopedics;
St. Petersburg State University

Email: fake@neicon.ru

Dr. Sci. (Med.), Professor, Head of Functional Group of External Fixation

Professor of the Surgery Chair, Medical Faculty

8, ul. Akad. Baykova, 195427, St. Petersburg

8a, 21 Liniya V.O., 199106, St. Petersburg

Russian Federation

K. L. Korchagin

Vreden Russian Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: korchagin.konstantin@gmail.com

Researcher Assistant

8, ul. Akad. Baykova, 195427, St. Petersburg

Russian Federation

R. S. Rozbruch

Limb Salvage and Amputation Reconstruction Center

Email: fake@neicon.ru

MD, Professor, Director

519 East 72nd Street Suite 204, New York

United States

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CrossRef: 2

  1. Solomin LN, Shchepkina EA, Korchagin KL, Buksbaum JR, Sheridan GA, Rozbruch SR. Knee Joint Bone Defects: Reconstruction With Bone Transport and Arthrodesis. The Journal of Arthroplasty. 2021;36(8):2896. doi: 10.1016/j.arth.2021.03.009
  2. Solomin LN, Shchepkina EA, Korchagin KL, Sabirov FK. Comparative Analysis of Knee Joint Fusion with Long Locking Nail and Ilizarov Apparatus in Patients with Deep Infection after Arthroplasty. Traumatology and Orthopedics of Russia. 2020;26(3):109. doi: 10.21823/2311-2905-2020-26-3-109-118

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