Patellofemoral instability after total knee arthroplasty.

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Abstract

[Indexed for MEDLINE] 6. Orthop Surg. 2019 Feb;11(1):15-24. doi: 10.1111/os.12425. Epub 2019 Feb 27. Bone Defects in Revision Total Knee Arthroplasty and Management. Lei PF(1), Hu RY(2), Hu YH(1). Author information: (1)Department of Orthopaedic Surgery, Xiangya Hospital of Central South University, Changsha, China. (2)Department of Orthopaedic Surgery, Guizhou Provincial People's Hospital, Guiyang, China. This article reviews the recent updates in revision of total knee arthroplasty (RTKA). We reviewed the recent articles on RTKA in databases including PubMed, Google Scholar, and SCOPUS. Total knee arthroplasty (TKA) involves the replacement of all three compartments of the knee in surgery of the knee joint to restore capacity and function. TKA is one of the most common and reliable surgical treatment options for the treatment of knee diseases. However, some patients require revision of TKA (RTKA) after primary TKA for various reasons, including mechanical wear, implant loosening or breakage, malalignment, infection, instability, periprosthetic fracture, and persistent stiffness. Unfortunately, the overall outcome of RTKA is not as satisfactory as for primary TKA due to the uncertainty regarding the actual success rate and the risk factors for failure. Cementation, modular metal augmentation, bone grafting, autologous bone grafting, allogenic bone grafting, impactation bone grafting, structural bone allografting, metaphyseal fixation, using porous titanium coated press fit metaphyseal sleeves and porous tantalum structural cones, and megaprostheses or customized prostheses are the currently available management options for RTKA. However, most of the management systems possess specific complications. Novel approaches should be developed to improve functional capacity, implant survival rates, and quality of life in a cost-efficient manner. © 2019 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. DOI: 10.1111/os.12425 PMCID: PMC6430493