Abstract:

BACKGROUND: Total knee arthroplasty revision is technically challenging compared with primary arthroplasty. Bone defect or injury of lateral collateral ligament increases the difficulty of prosthesis fixation, component alignment and stability reconstruction.
OBJECTIVE: To explore the clinical results of metal augmentation and intramedullary stem in total knee arthroplasty revision. 
METHODS: A retrospective study was performed through the use of metal augmentation and intramedullary stem for uncontained bone defects (AORI Type Ⅱ) in 12 total knee arthroplasties from February 2004 to January 2008, including 8 cases revision due to aseptic loosening and 4 cases due to infection. The prosthesis was OPTETRAK.CCK. The patients were followed up after revision, and evaluated by HSS scores.
RESULTS AND CONCLUSION: The patients were followed up for a mean of 21 months (range, 6 to 37 months). Clinical evaluation revealed that the mean knee score of the HSS had improved from 27 points preoperatively to 75 points postoperatively, and the mean range of motion had increased from a flexion arc of 63° to 97°. Except a delayed healing in one case, no lower limb phlebothrombosis or pulmonary infection occurred. Metal augmentation for uncontained bone defects and soft tissue balance combined with intramedullary stem is feasible to accomplish, it provides immediate secure fixation to host bone, and enhances success rate of knee arthroplasty revision.