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J Knee Surg 2013; 26(01): 065-068
DOI: 10.1055/s-0032-1319786
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Revision Total Knee Arthroplasty after Severe Notching of the Anterior Femoral Cortex

Matthew C. Kinney
1   Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia
,
Atul F. Kamath
2   Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
,
Roshan P. Shah
2   Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
,
Craig L. Israelite
2   Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
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Publikationsverlauf

04. Februar 2012

12. Februar 2012

Publikationsdatum:
28. Juni 2012 (online)

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Abstract

Anterior femoral cortex notching is a known complication of total knee arthroplasty (TKA). In severe cases, notching may alter the mechanical properties of the distal femur. We report a patient with significant femoral notching and malpositioning of the femoral prosthesis after TKA, leading to unresolved postoperative pain, decreased range of motion, and functional disability. The severity of this lesion required the use of augments and an offset femoral stem for improved alignment during revision arthroplasty, which is described in this brief technical note.

Keywords

revision total knee arthroplasty - anterior femoral notching - augmentation - complications
 

  • References

  • 1 Ritter MA, Faris PM, Keating EM. Anterior femoral notching and ipsilateral supracondylar femur fracture in total knee arthroplasty. J Arthroplasty 1988; 3 (2) 185-187
    CrossrefPubMedSuche in Google Scholar
  • 2 Ritter MA, Thong AE, Keating EM , et al. The effect of femoral notching during total knee arthroplasty on the prevalence of postoperative femoral fractures and on clinical outcome. J Bone Joint Surg Am 2005; 87 (11) 2411-2414
    CrossrefPubMedSuche in Google Scholar
  • 3 Lesh ML, Schneider DJ, Deol G, Davis B, Jacobs CR, Pellegrini Jr VD. The consequences of anterior femoral notching in total knee arthroplasty. A biomechanical study. J Bone Joint Surg Am 2000; 82-A (8) 1096-1101
    PubMedSuche in Google Scholar
  • 4 Zalzal P, Backstein D, Gross AE, Papini M. Notching of the anterior femoral cortex during total knee arthroplasty characteristics that increase local stresses. J Arthroplasty 2006; 21 (5) 737-743
    CrossrefPubMedSuche in Google Scholar
  • 5 Hoeffel DP, Rubash HE. Revision total knee arthroplasty: current rationale and techniques for femoral component revision. Clin Orthop Relat Res 2000; 380 (380) 116-132
    CrossrefPubMedSuche in Google Scholar
  • 6 Dennis DA. Repairing minor bone defects: augmentation & autograft. Orthopedics 1998; 21 (9) 1036-1038
    PubMedSuche in Google Scholar
  • 7 Werle JR, Goodman SB, Imrie SN. Revision total knee arthroplasty using large distal femoral augments for severe metaphyseal bone deficiency: a preliminary study. Orthopedics 2002; 25 (3) 325-327
    CrossrefPubMedSuche in Google Scholar
  • 8 Minoda Y, Kobayashi A, Iwaki H , et al. The risk of notching the anterior femoral cortex with the use of navigation systems in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2010; 18 (6) 718-722
    CrossrefPubMedSuche in Google Scholar
  • 9 Gandhi R, Smith H, Lefaivre KA, Davey JR, Mahomed NN. Complications after minimally invasive total knee arthroplasty as compared with traditional incision techniques: a meta-analysis. J Arthroplasty 2011; 26 (1) 29-35
    CrossrefPubMedSuche in Google Scholar