Volume 4, Issue 3, Pages (September 2018)

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Presentation transcript:

Volume 4, Issue 3, Pages 313-318 (September 2018) Acetabular wedge augments for uncontained tibial plateau defects in revision total knee arthroplasty Jeffrey B. Stambough, MD, Jacob A. Haynes, MD, Robert L. Barrack, MD, Ryan M. Nunley, MD Arthroplasty Today Volume 4, Issue 3, Pages 313-318 (September 2018) DOI: 10.1016/j.artd.2018.02.005 Copyright © 2018 The Authors Terms and Conditions

Figure 1 Representative anteroposterior (AP) (a) and lateral (b) knee radiograph demonstrating significant varus collapse of primary tibial base tray with significant metaphyseal bone loss. Arthroplasty Today 2018 4, 313-318DOI: (10.1016/j.artd.2018.02.005) Copyright © 2018 The Authors Terms and Conditions

Figure 2 Intraoperative image demonstrating placement of acetabular augment and securing in a buttress fashion with placement of screws from medial to lateral with final packing of bone graft around the augment. Alternatively, this can be cemented into place and remaining slots can be filled with bone graft substitute before final closure. Arthroplasty Today 2018 4, 313-318DOI: (10.1016/j.artd.2018.02.005) Copyright © 2018 The Authors Terms and Conditions

Figure 3 Postoperative AP (a) and lateral (b) single limb knee radiographs as well as bilateral knee (c) and hip-knee-ankle (d) EOS biplanar images showing the final construct with supporting wedge augment cemented into position supporting revision tibial tray and restoration appropriate coronal limb alignment. Arthroplasty Today 2018 4, 313-318DOI: (10.1016/j.artd.2018.02.005) Copyright © 2018 The Authors Terms and Conditions

Figure 4 Preresection AP knee radiograph (a) of a patient with severe osteolysis, medial tibial bone destruction, and a concomitant periprosthetic joint infection. After 2-stage exchange arthroplasty, a wedge augment was needed for an uncontained medial defect and subsequent AP (b) and lateral (c) radiographs at 2-year follow-up show endoprosthetic reconstruction with stable, supportive medial wedge buttress augment. Arthroplasty Today 2018 4, 313-318DOI: (10.1016/j.artd.2018.02.005) Copyright © 2018 The Authors Terms and Conditions

Figure 5 Preresection AP knee radiograph (a) of a patient with prior tibial plateau fracture who had extreme medial-sided collapse and a large, hemiplateau defect. At 10-year follow-up, the patient is doing well and AP (b) and lateral (c) radiographs demonstrate a stable reconstruction of the medial metaphysis using the buttress wedge augment with maintained tray and component positioning. Arthroplasty Today 2018 4, 313-318DOI: (10.1016/j.artd.2018.02.005) Copyright © 2018 The Authors Terms and Conditions