CASE REPORT

A Case Report: Custom Made Porous Titanium Implants in Revision: A New Option for Complex Issues

The Open Orthopaedics Journal 30 Nov 2018 CASE REPORT DOI: 10.2174/1874325001812010525

Abstract

Background:

Bone loss management is considered one of the most difficult challenges for orthopaedic surgeon. In massive bone defects, few surgical options are available and they do not offer a reliable or optimal solution for knee reconstruction.

Objective:

The aim of this paper is to present and justify a new custom-made approach for complex metadiaphyseal bone defects management in knee revision surgery.

Methods:

We report a case of a 66-year-old woman who underwent a staged left total knee arthroplasty revision for infection with Anderson Orthopaedic Research Institute classification III uncontained femoral and tibial metadiaphyseal bone defects following five prior surgeries. Along with a case discussion, we describe clinical and radiological outcomes of 3 similar patients treated with this new custom-made device.

Results:

To manage these problems, we developed new, custom porous titanium devices for both femoral and tibial reconstruction tailored to a patient’s specific bone loss. Since, 2014, we treated four cases using custom-made porous titanium cones and we had optimal clinical and radiological results, with no instances of loosening, component migration, or mismatches between preoperative planning and intraoperative findings.

Conclusion:

In extremely selected cases, this new device can be considered a possible and viable surgical step between “off the shelf” reconstruction implants and knee substitution with a tumor megaprosthesis.

Keywords: Revision TKA, Periprosthetic joint infection, Bone defect, Custom made, Novel implant, Porous titanium, Porous metal, Outcome.
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