Chang Hyun Shin
Wonkwang University Hospital, South Korea
Title: Comparison of using Trabecular metal cones and femoral head allografts for large bone defect in revision TKA
Biography:
Dr. Chun has expertise in knee joint replacement and its supportive surgeries. He was a guest professor in UCLA (1994) and Indiana university medical center (2002~2004). He is a board member of Korean orthopaedic association, was the chairman of Korean knee society, Korean society of sports medicine and Korean society of arthroscopy. He has published various theses on many world-known journals such as Cell, Nature, the Journal of arthroplasty, the American Journal of Sports Medicine and Knee surgery & related research. He works in the orthopaedic department of Wonkwang university hospital, Iksan, Korea, as a chief professor specializing in the knee joint.
Abstract:
We compared using trabecular metal cones or femoral head allografts in revision TKA patients with large bone defect.
Methods: Total 53 patients who underwent revision TKA from July 2013 to March 2017 were enrolled in this study. Among them, 24 used trabecular metal cones (3 males and 21 females), and 29 used femoral head allografts (4 males and 25 females). The mean age was 70.2 years (range, 51-80) in the allograft group and 79.1 (range, 73-85) in the cone group.
Bone defect was classified with AORI classification and clinical outcomes were evaluated with VAS, HSS, WOMAC, KOOS and ROM. We checked operation time and used radiographs to check loosening. Shapiro-Wilk test was used to check normality and Student T-test and Mann Whitney U-test for comparison between two groups.
Results: The mean follow-up period was 3.75 years (Range; 2.1 ~ 5.75). The mean VAS in the allograft and cone groups were 2.1 ± 0.87 and 1.8 ± 0.53, respectively (p = 0.16). The mean HSS scores were 76.3 ± 5.51 and 79.2 ± 4.12 (p = 0.13), the mean WOMAC scores were 15.1 ± 3.25 and 14.8 ± 3.31 (p = 0.06), the mean KOOS scores were 27.8 ± 4.77 and 25.5 ± 4.84 (p = 0.07), and the mean ROM ranges were 100.6 ± 17.54 and 101.3 ± 19.22 (p = 0.09). Complications with implants were not found in both groups. But the mean operation time of the allograft and trabecular metal cone groups was 137 minutes (Range; 111-198) and 102 minutes (Range; 93 -133) (p=0.02) respectively, which showed statistical significance.
Conclusion: Using whichever means did not affect clinical outcomes. However, operation time was significantly shorter in cone group. In patients with poor general condition, using trabecular metal cone can help shorten operation time and ease postoperative care.