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Management of Tibial Bone Loss

  • Giles R. Scuderi
  • Thomas J. Parisi
  • Douglas A. DennisEmail author
  • David G. Lewallen
  • Russell E. WindsorEmail author
  • Danielle Y. Ponzio
Chapter

Abstract

Severe tibial bone loss is one of the most challenging aspects in revision total knee arthroplasty (TKA). Bone loss can be the result of (1) aseptic failure with component loosening, subsidence, osteolysis, and fracture, (2) septic failure with bone resorption and osteolysis, and (3) iatrogenic bone loss following component removal. Accurate assessment of the severity of the tibial bone loss is necessary, especially in the proximal metaphysis, since it impacts tibial component position and fixation. Despite several classification systems, the radiographic evaluation of the bone defects is often difficult and underestimated [1]. The final determination of tibial bone loss is made at the time of surgery. The most useful classification system is the Anderson Orthopaedic Research Institute (AORI) classification that describes the severity of the tibial bone loss based upon the integrity of the metaphysis and whether one or both plateaus are involved [2].

Keywords

Tibial bone loss Tibial bone graft Tibial augments and cones Proximal tibial prosthesis 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Giles R. Scuderi
    • 1
  • Thomas J. Parisi
    • 2
  • Douglas A. Dennis
    • 2
    • 3
    • 4
    Email author
  • David G. Lewallen
    • 5
  • Russell E. Windsor
    • 6
    Email author
  • Danielle Y. Ponzio
    • 7
  1. 1.Northwell Health Orthopedic InstituteNew YorkUSA
  2. 2.Colorado Joint ReplacementPorter Adventist HospitalDenverUSA
  3. 3.Department of Biomedical Mechanical and Materials EngineeringUniversity of TennesseeKnoxvilleUSA
  4. 4.Department of OrthopedicsUniversity of Colorado School of MedicineAuroraUSA
  5. 5.Department of Orthopedic SurgeryMayo ClinicRochesterUSA
  6. 6.Department of Orthopaedic Surgery, Hospital for Special SurgeryWeill Cornell University Medical CollegeNew YorkUSA
  7. 7.Adult Reconstruction and Joint ReplacementHospital for Special SurgeryNew YorkUSA

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