Department of Orthopaedic Surgery, Postgraduate Institute of Medical Education & Research, #123-C, Old Type V, Sector 24A, Chandigarh, India.
Musculoskelet Surg. 2021 Apr;105(1):31-38. doi: 10.1007/s12306-020-00683-7. Epub 2020 Oct 15.
While tackling with bone deficiencies in the context of total knee arthroplasty, it is imperative for the arthroplasty surgeon to arm himself with an in-depth knowledge on the various management options available and to use the right option for the right type of defect in the right patient. Aim of this review paper is to focus on the various options available and discuss the evolving concepts and recent trends with regard to the implications and treatment of bone deficiencies, in primary total knee arthroplasty. Relevant literature is evaluated with specific focus on the modality used for managing a defect, their clinical and radiological outcomes and failure rates. Out of various classifications described, Anderson Orthopaedic Research Institute (AORI) system is universally employed to classify the bone defects. The currently available management options include more tibial resection, the use of bone cement to fill the defect, with or without augmentation with screws, bone grafting which may be autograft or allograft, metal augments, metaphyseal cones and sleeves. There is no single option which can be applied universally; each has its own advantages, disadvantages and specific indications with regard to application in specific types of defects, in specific patients as outlined in this article.
在全膝关节置换术中处理骨缺损时，关节置换外科医生必须深入了解各种可用的管理方案，并为合适的患者的合适类型的缺损选择正确的方案。本文的目的是聚焦于各种可用的方案，并讨论与原发性全膝关节置换术中骨缺损的处理相关的不断发展的概念和最新趋势。本文通过具体关注用于处理缺陷的方法、其临床和放射学结果以及失败率，对相关文献进行了评估。在描述的各种分类中，安德森骨科研究所（AORI）系统被普遍用于对骨缺损进行分类。目前可用的管理方案包括更多的胫骨切除、使用骨水泥填充缺损、使用或不使用螺钉进行增强、同种异体或异体骨移植、金属增强物、干骺端圆锥和套管。没有一种单一的方案可以普遍应用；每种方案都有其自身的优缺点和特定的适应证，适用于本文中概述的特定类型的缺陷和特定患者。
