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
Article Information
Identifiers and Pagination:
Year: 2018Volume: 12
First Page: 525
Last Page: 535
Publisher ID: TOORTHJ-12-525
DOI: 10.2174/1874325001812010525
Article History:
Received Date: 9/7/2018Revision Received Date: 14/11/2018
Acceptance Date: 20/11/2018
Electronic publication date: 30/11/2018
Collection year: 2018
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.
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.