Master Techniques in Orthopedic Surgery Knee CH21

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PART IV Revision Total Knee Arthroplasty

FIGURE 21-1. Type I bone loss has intact metaphyseal bone with less than 5 mm of bone loss.

●● AORI type II defects (Figure 21-2), whether unicondylar or bicondylar, including uncontained defects up to 20 mm in depth, can usually be addressed with porous metaphyseal cones (tantalum or titanium). Some type I and smaller type IIA defects may be treated with metal sleeves. ●● AORI type III defects (Figure 21-3) have historically been managed with structural allograft bone, APCs, or segmental replacement prostheses. However, the introduction of porous tantalum and titanium cones, which can be used with a variety of prosthesis systems, has largely replaced our use of structural allografts. 7

FIGURE 21-2. Type II bone loss has damaged metaphyseal bone with loss of cancellous bone. A involves only one condyle or plateau, whereas B involves both condyles or both plateaus.

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