The Open Orthopaedics Journal




ISSN: 1874-3250 ― Volume 13, 2019
CASE REPORT

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



Giorgio Burastero1, Luca Cavagnaro1, *, Francesco Chiarlone2, Bernardo Innocenti3, Lamberto Felli2
1 Department of Orthopaedic and Traumatology 2, Joint Replacement Unit, Azienda Ospedaliera Santa Corona, via XXV Aprile 38 Pietra Ligure (SV), Italy
2 Department of Orthopaedic, Policlinico San Martino Largo Rosanna Benzi 10, 16132 GENOVA, (GE), Italy
3 Department of BEAMS, École Polytechnique de Bruxelles, Université Libre de Bruxelles, Bruxelles, Belgium

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.


Article Information


Identifiers and Pagination:

Year: 2018
Volume: 12
First Page: 525
Last Page: 535
Publisher Id: TOORTHJ-12-525
DOI: 10.2174/1874325001812010525

Article History:

Received Date: 9/7/2018
Revision Received Date: 14/11/2018
Acceptance Date: 20/11/2018
Electronic publication date: 30/11/2018
Collection year: 2018

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© 2018 Burastero et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Department of Orthopaedic and Traumatology 2, Joint Replacement Unit, Azienda Ospedaliera Santa Corona, via XXV Aprile 38 Pietra Ligure (SV), Italy; Tel: + 39 3333011814; E-mail: cavagnaro.luca@libero.it


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