Unicondylar Osteoarticular Allografts of the Knee

Muscolo, D. Luis; Ayerza, Miguel A.; Aponte-Tinao, Luis A.; Abalo, Eduardo; Farfalli, German
October 2007
Journal of Bone & Joint Surgery, American Volume;Oct2007, Vol. 89-A Issue 10, p2137
Academic Journal
Background: In the management of a resected distal femoral or proximal tibial condyle as the result of tumor or trauma, a unicondylar osteoarticular allograft is currently the only reconstructive option that avoids the sacrifice of the unaffected condyle. The purposes of this study were to perform a survival analysis of unicondylar osteoarticular allografts of the knee and to evaluate the complications. Methods: We retrospectively reviewed the results of forty large unicondylar osteoarticular allograft procedures in thirty-eight patients who were followed for a mean of eleven years. Twenty-nine allografts were femoral transplants and included eleven medial and eighteen lateral femoral condyles. Eleven allografts were tibial transplants, including four medial and seven lateral tibial condyles. The procedure was performed after a tumor resection in thirty-six patients and to replace condylar loss after a severe open fracture in the remaining two patients. Complications were analyzed, and allograft survival from the date of implantation to the date of revision or the time of the latest follow-up was determined. Functional and radiographic results were documented according to the Musculoskeletal Tumor Society scoring system at the time of the latest follow-up. Results: One patient died of tumor-related causes without allograft failure before the two-year follow-up evaluation. The global rate of allograft survival at both five and ten years was 85%, with a mean follow-up of 148 months. In six patients, the allografts were removed at an average of twenty-six months (range, six to forty-eight months) and these were considered failures. All six patients underwent a second allograft procedure including two new unicondylar and four bicondylar reconstructions. The mean radiographic score for the thirty-three surviving allografts evaluated was 89%, with an average functional score of 27 of a possible 30 points. Conclusions: Unicondylar osteoarticular allografts of the knee appear to be a reliable alternative for patients in whom reconstruction of massive osteoarticular bone loss is limited to one condyle of the femur or the tibia. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


Related Articles

  • Structural Femoral Head Allografting With Revision TKA. Engh, Gerard A. // Orthopedics;Sep2004, Vol. 27 Issue 9, p999 

    Presents a surgical technique for structural femoral head allografting with revision total knee arthroplasty. Advantages of using structural allograft; Technique for preparing the host bone; Approach to facilitate union with the graft.

  • Alignment for total knee replacement: a comparison of kinematic axis versus mechanical axis techniques. A cadaver study. Nogler, Michael; Hozack, William; Collopy, Dermot; Mayr, Eckart; Deirmengian, Gregory; Sekyra, Kathrin // International Orthopaedics;Nov2012, Vol. 36 Issue 11, p2249 

    Purpose: Standard instrumentation tries to reproduce mechanical axes based on mechanical alignment (MA) guides. A kinematic alignment (KA) technique derives its plan from pre-operative MRI-measurements. This matched-pair cadaveric study compared the resulting postoperative alignments. Methods: A...

  • Evaluation of tibial rotational alignment in total knee arthroplasty: a cadaver study. Rossi, Roberto; Bruzzone, Matteo; Bonasia, Davide Edoardo; Marmotti, Antonio; Castoldi, Filippo // Knee Surgery, Sports Traumatology, Arthroscopy;Jul2010, Vol. 18 Issue 7, p889 

    Various techniques exist for establishing tibial rotational alignment during total knee arthroplasty (TKA). The purpose of this study is to establish the most precise and reproducible method to assess tibial component rotational alignment during TKA by comparing the flexion-extension technique...

  • Accuracy Evaluation of a Shape-Based Registration Method for a Computer Navigation System for Total Knee Arthroplasty. Nishihara, Shunsaku; Sugano, Nobuhiko; Ikai, Miho; Sasama, Toshihiko; Tamura, Yuichi; Tamura, Shinichi; Yoshikawa, Hideki; Ochi, Takahiro // Journal of Knee Surgery (SLACK Incorporated);Apr2003, Vol. 16 Issue 2, p98 

    This study evaluated the effect of computed tomography (CT) slice thickness, reconstruction pitch, intraoperative data sampling area, and data sampling volume on the accuracy of registration and determined a clinically acceptable trade-off between accuracy and surgical invasiveness. One...

  • Knee Arthroplasty With a Medially Conforming Ball-and-Socket Tibiofemoral Articulation Provides Better Function. Hossain, Fahad; Patel, Shelain; Rhee, Shin-Jae; Haddad, Fares Sami // Clinical Orthopaedics & Related Research;Jan2011, Vol. 469 Issue 1, p55 

    Background: A knee design with a ball-and-socket articulation of the medial compartment has a femoral rollback profile similar to the native knee. Compared to a conventional, posterior-stabilized knee design, it provides AP stability throughout the entire ROM. However, it is unclear whether this...

  • Distraction arthrodesis with intramedullary nail and mixed bone grafting after failed infected total knee arthroplasty. Lee, Sahnghoon; Jang, Jak; Seong, Sang; Lee, Myung // Knee Surgery, Sports Traumatology, Arthroscopy;Feb2012, Vol. 20 Issue 2, p346 

    Purpose: The purpose of this study was to determine the success rate of the distraction arthrodesis, which was attempted to maintain the limb length during arthrodesis using an intramedullary nail and mixed bone grafting, in terms of the eradication of infection, solid union, and functional...

  • WHAT'S NEW IN ADULT RECONSTRUCTIVE KNEE SURGERY. Archibeck, Michael J.; White Jr., Richard E. // Journal of Bone & Joint Surgery, American Volume;Jul2006, Vol. 88-A Issue 7, p1677 

    The article presents developments related to adult reconstruction knee surgery. The use of fresh osteochondral allografts is reported to be effective in knee surgery. Perioperative pain management has gained attention from the medical community because of its contribution to rapid recovery and...

  • Management of Bone Defects in Revision Total Knee Arthroplasty. Daines, Brian K.; Dennis, Douglas A. // Journal of Bone & Joint Surgery, American Volume;6/20/2012, Vol. 94-A Issue 12, p1132 

    The article focuses on surgical management of bone loss associated with revision total knee arthroplasty. It discusses the importance of proper evaluation of patients before operation which helps in deciding the best suitable treatment method. Various surgical options include increasing bone...

  • Revision of 33 unicompartmental knee prostheses using total knee arthroplasty: strategy and results. Saragaglia, Dominique; Estour, Gilles; Nemer, Charbel; Colle, Pierre-Emmanuel // International Orthopaedics;Aug2009, Vol. 33 Issue 4, p969 

    The purpose of this study was twofold: to evaluate the radiological and clinical results of 33 total knee arthroplasties (TKA) implanted between January 1993 and March 2005, to replace failed medial unicompartmental knee arthroplasty (UKA), and to develop a strategy to deal with bone defects in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics