Boettner Friedrich, Bechler Ulrich, Springer Bernhard, Faschingbauer Martin, Jungwirth-Weinberger Anna
Adult Reconstruction and Joint Replacement Department, Hospital for Special Surgery, New York, NY, USA.
Department of Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Arthroplast Today. 2020 Aug 10;6(3):578-584. doi: 10.1016/j.artd.2020.07.001. eCollection 2020 Sep.
Uncontained tibial bone defects are a challenge in revision total knee arthroplasty. The present study reports on the results of a modified surgical technique for impaction bone grafting using metaphyseal cones and wire mesh. Three patients (2 male, 1 female; average age: 71.3 years) underwent revision total knee arthroplasty. All patients presented with uncontained medial tibial bone defects, one of the patients with an additional posterior cortical tibial split fracture. All cases were treated with a metaphyseal cone and outside mesh to create a contained defect. Between the mesh and cone, fresh frozen cancellous chips mixed with β-tricalcium phosphate were impacted. No evidence of loosening or osteolysis was present at 3.6-year follow-up. Impaction bone grafting using an outside mesh and inside cone for defect containment provides a durable reconstruction of tibial bone defects.
非包容性胫骨骨缺损是全膝关节置换翻修手术中的一项挑战。本研究报告了一种使用干骺端锥体和金属丝网进行嵌压植骨的改良手术技术的结果。三名患者（2名男性，1名女性；平均年龄：71.3岁）接受了全膝关节置换翻修手术。所有患者均存在非包容性内侧胫骨骨缺损，其中一名患者还伴有胫骨后侧皮质劈裂骨折。所有病例均采用干骺端锥体和外侧金属丝网来形成包容性缺损。在金属丝网和锥体之间，将新鲜冷冻的松质骨碎片与β-磷酸三钙混合后进行嵌压。在3.6年的随访中，未发现松动或骨溶解迹象。使用外侧金属丝网和内侧锥体进行缺损包容的嵌压植骨可为胫骨骨缺损提供持久的重建。
