Anterolateral Oblique Distal Femoral Osteotomy for the Removal of Well Fixed Cemented Femoral TKA Components
Keywords:Distal femoral osteotomy, Revision TKA, Complex Revision
In the setting of periprosthetic joint infection, the complete removal of implants and cement can be challenging with well-fixed, cemented implants about the knee. This can get especially complex in the setting of long cemented femoral component stems. Osteotomies are well described in the proximal femur and tibia for removal of implants and cement. There is little information available on distal femoral osteotomies. We describe an anterolateral oblique distal femoral osteotomy for the removal of well-fixed, cemented components in resection knee arthroplasty that preserves vascularity to the osteotomized segment.
Massin P, Boyer P, Sabourin M, Jeanrot C. Removal of infected cemented hinge knee prostheses using extended femoral and tibial osteotomies: Six cases. Orthop Traumatol Surg Res. 2012;98(7):840-844.
Masri BA, Mitchell PA, Duncan CP. Removal of solidly fixed implants during revision hip and knee arthroplasty. J Am Acad Orthop Surg. 2005;13(1):18-27.
Mason JB, Fehring TK. Removing well-fixed total knee arthroplasty implants. Clin Orthop Relat Res. 2006;446:76-82.
Glassman AH, Engh CA, Bobyn JD. A technique of extensile exposure for total hip arthroplasty. J Arthroplasty. 1987;2(1):11-21.
Glassman AH. Exposure for revision: Total hip replacement. Clin Orthop Relat Res. 2004;(420)(420):39-47.
Archibeck MJ, Rosenberg AG, Berger RA, Silverton CD. Trochanteric osteotomy and fixation during total hip arthroplasty. J Am Acad Orthop Surg. 2003;11(3):163-173.
Whiteside LA, Ohl MD. Tibial tubercle osteotomy for exposure of the difficult total knee arthroplasty. Clin Orthop Relat Res. 1990;(260)(260):6-9.
Whiteside LA. Exposure in difficult total knee arthroplasty using tibial tubercle osteotomy. Clin Orthop Relat Res. 1995;(321)(321):32-35.
Merz MK, Farid YR. Anterior distal femoral osteotomy for removal of long femoral stems in revision knee arthroplasty. J Arthroplasty. 2014;29(7):1423-1425.
Penteado CV, Masquelet AC, Romana MC, Chevrel JP. Periosteal flaps: Anatomical bases of sites of elevation. Surg Radiol Anat. 1990;12(1):3-7.
ROGERS WM, GLADSTONE H. Vascular foramina and arterial supply of the distal end of the femur. J Bone Joint Surg Am. 1950;32(A:4):867-874.
How to Cite
Copyright (c) 2017 J. Ryan Martin
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright and License Agreement:
Authors who publish with the Reconstructive Review agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work. Reconstructive Review follows the Creative Commons Attribution-NonCommercial CC BY-NC. This license allows anyone to download works, build upon the material, and share them with others for non-commercial purposes as long as they credit the senior author, Reconstructive Review, and the Joint Implant Surgery & Research Foundation (JISRF). An example credit would be: "Courtesy of (senior author's name), Reconstructive Review, JISRF, Chagrin Falls, Ohio". While works can be downloaded and shared they cannot be used commercially.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.