The Journal of Bone and Joint Surgery, Vol 77, Issue 3 373-386, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Arthroplasty with a composite of an allograft and a prosthesis for knees with severe deficiency of bone
AI Harris, S Poddar, S Gitelis, MB Sheinkop and AG Rosenberg
Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois.
We reviewed the clinical and radiographic results of fourteen patients who
had a severe deficiency of bone and were managed with a massive allograft
in conjunction with a standard total knee prosthesis between 1987 and 1990.
The etiology of the bone loss included the failure of a previous total knee
prosthesis, a supracondylar fracture of the femur or a fracture of the
proximal part of the tibia, and debridement during the first stage of a
reconstruction for the treatment of an infection. Thirteen patients had
satisfactory clinical and radiographic results after the index procedure.
The knee score of The Hospital for Special Surgery improved from an average
of 24 points (range, 0 to 54 points) preoperatively to 82 points (range, 37
to 98 points) at the time of the most recent follow-up examination. The
average duration of follow-up was forty-three months (range, twenty-nine to
sixty-three months). The radiographic and functional results compare
favorably with those that have been reported in most studies of otherwise
comparable patients who had less deficiency of bone. While considerable
risks are associated with the use of allograft bone and the true longevity
of reconstructions with such bone is not yet known, the initial and
short-term follow-up results support the use of allograft for the
restoration of a functional knee joint in a patient who has a severe
deficiency of bone.
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