Morselized bone grafting in revision arthroplasty of the knee: a retrospective analysis of 34 reconstructions after 2-9 years.

Background And Purpose: Loosening of a total knee replacement may lead to loss of bone, requiring biological reconstruction at revision arthroplasty. Good results have been reported from revision arthroplasty of the hip using impaction bone grafting. We report our results of revision total knee arthroplasty using the same technique.

Patients And Methods: We retrospectively analyzed 30 patients (involving 34 knees) with a mean age of 63 (34-81) years who, between 1994 and 2002, underwent revision arthroplasty of the knee using hinge or rotational knee prostheses (Link) and impaction bone grafting. The average follow-up was 4 (2-9) years and included a questionnaire, a clinical examination, and standardized radiographs.

Results: 25 patients were satisfied with their results. 10 patients reported no impairment in their activities of daily living attributed to their operation and did not need any walking support. In 5 patients, there were no clear radiographic signs of incorporation of the graft but that did not compromise the outcome. 5 other patients had complications due to aseptic loosening of their prostheses with radiographic failure of the graft, leading to a periprosthetic fracture in 2 cases.

Interpretation: Our results with impaction bone grafting in knee revision arthroplasty appear to be similar to those obtained by the same technique in revision hip surgery.