Treatment of Major Defects of Bone with Bulk Allografts and Stemmed Components during Total Knee Arthroplasty* by GERARD A. ENGH, PAUL J. HERZWURM, and.

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Presentation transcript:

Treatment of Major Defects of Bone with Bulk Allografts and Stemmed Components during Total Knee Arthroplasty* by GERARD A. ENGH, PAUL J. HERZWURM, and NANCY L. PARKS J Bone Joint Surg Am Volume 79(7): July 1, 1997 ©1997 by The Journal of Bone and Joint Surgery, Inc.

Figs. 1-A through 1-D: Photographs showing repair of a defect with use of a femoral-head allograpft in a revision total knee arthroplasty. GERARD A. ENGH et al. J Bone Joint Surg Am 1997;79: ©1997 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-B: The femoral-head allograft is prepared with use of female-type reamers (Allogrip; DePuy). GERARD A. ENGH et al. J Bone Joint Surg Am 1997;79: ©1997 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-C The femoral-head allograft is placed in the prepared host bed and is secured by an interference fit and temporary stabilization with Kirschner wires. GERARD A. ENGH et al. J Bone Joint Surg Am 1997;79: ©1997 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-D The allograft and the bone in the distal part of the femur are resected to allow the revision femoral component with a canal-filling stem to be inserted with cement. GERARD A. ENGH et al. J Bone Joint Surg Am 1997;79: ©1997 by The Journal of Bone and Joint Surgery, Inc.

Figs. 2-A, 2-B, and 2-C: Case 13. GERARD A. ENGH et al. J Bone Joint Surg Am 1997;79: ©1997 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-B: Radiograph made six weeks postoperatively, showing demarcation of the host-graft junction (arrows), a tibial base-plate that had been inserted with cement, and a stem that had been inserted without cement. GERARD A. ENGH et al. J Bone Joint Surg Am 1997;79: ©1997 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-C Radiograph made four years postoperatively, showing obliteration of the host-graft junction (arrows), no change in the position of the component, and no radiolucent lines adjacent to the component. GERARD A. ENGH et al. J Bone Joint Surg Am 1997;79: ©1997 by The Journal of Bone and Joint Surgery, Inc.

Figs. 3-A, 3-B, and 3-C: Case 5. GERARD A. ENGH et al. J Bone Joint Surg Am 1997;79: ©1997 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-B Radiograph made six weeks after revision, at which time femoral-head allografts (1 and 2) had been needed to repair extensive osteolytic lesions in both the medial and the lateral tibial plateau. GERARD A. ENGH et al. J Bone Joint Surg Am 1997;79: ©1997 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-C Radiograph made four years after revision with placement of the grafts (1 and 2), showing partial obliteration of the host-graft junctions (arrows) with most of each junction still visible. GERARD A. ENGH et al. J Bone Joint Surg Am 1997;79: ©1997 by The Journal of Bone and Joint Surgery, Inc.