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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 8, 981-987.
doi: 10.1302/0301-620X.90B8.19948  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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The management of bone loss in revision total knee replacement

J. P. Whittaker, FRCS(Orth), Fellow1; R. Dharmarajan, FRCS(Trauma & Orth), Consultant Trauma and Orthopaedic Surgeon2; and A. D. Toms, MSc, FRCS(Orth), Consultant Orthopaedic Surgeon1

1 Exeter Knee Reconstruction Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon & Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK.
2 Cumberland Infirmary, Newtown Road, Carlisle CA11 9QW, UK.

Correspondence should be sent to Mr A. D. Toms; e-mail: Andrew.Toms{at}rdeft.nhs.uk

The management of bone loss in revision replacement of the knee remains a challenge despite an array of options available to the surgeon. Bone loss may occur as a result of the original disease, the design of the prosthesis, the mechanism of failure or technical error at initial surgery. The aim of revision surgery is to relieve pain and improve function while addressing the mechanism of failure in order to reconstruct a stable platform with transfer of load to the host bone. Methods of reconstruction include the use of cement, modular metal augmentation of prostheses, custom-made, tumour-type or hinged implants and bone grafting.

The published results of the surgical techniques are summarised and a guide for the management of bone defects in revision surgery of the knee is presented.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General