Abstract
Introduction: Seven patients underwent successful revision total knee replacement for aseptic loosening. Bovine bone graft was used to reconstruct bony defects in all.
Materials and methods: This is a retrospective review. Between April 2000 and March 2003, bovine bone (Tutobone™, Wescott-Medical, UK) was used in 7 revision arthroplasty cases (4 right knees & 3 left). There were 5 males and 2 females. The average age was 70.4 years. All revisions were carried out for aseptic loosening of the prostheses associated with massive osteolysis and bone loss.
The bone defects on the tibia and femur were as follows: (Obtained from operative records. Classified according to Anderson Orthopaedic Research Institute classification)
| Type I | Type IIA | Type IIB | Type III | |
|---|---|---|---|---|
| TIBIA | 3 | 1 | 2 | 1 |
| FEMUR | 2 | 3 | 2 | 0 |
The tibial defects were corrected by impaction grafting and femoral condyle defects were corrected by using bovine bone as bulk grafts. Semi-constrained constrained stemmed cemented modular knee prostheses (TC3, Depuy) were used in all. Clinical outcomes were recorded by the Oxford Knee Score. Serial radiographs were evaluated for graft density, integration, implant loosening, alignment and subsidence.
Results: At recent follow-up, radiographs showed good graft integration, no loosening, and no subsidence of the implant and good prostheses alignment. The average Oxford Knee Score was 20.4.
Conclusion & discussion: Bovine bone substitute is an alternative. The bone defects in these patients were successfully reconstructed with bovine bone. It is an osteo-conductive matrix with intact type-I collagen that provides mechanical stability. It is also cost effective.
Early results are encouraging but long-tem follow-up is needed.
Correspondence should be addressed to Roger Smith, Honorary Secretary, BASK c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PN
