Anterolateral Oblique Distal Femoral Osteotomy for the Removal of Well Fixed Cemented Femoral TKA Components

  • Keith A. Fehring OrthoCarolina Department of Orthopaedic Surgery Charlotte, NC
  • Cody C. Wyles Mayo Clinic Department of Orthopaedic Surgery Rochester, MN
  • J. Ryan Martin OrthoCarolina
  • Robert T. Trousdale Mayo Clinic Department of Orthopaedic Surgery Rochester,
Keywords: Distal femoral osteotomy, Revision TKA, Complex Revision

Abstract

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.

Author Biographies

Keith A. Fehring, OrthoCarolina Department of Orthopaedic Surgery Charlotte, NC
MD
Cody C. Wyles, Mayo Clinic Department of Orthopaedic Surgery Rochester, MN
MD
J. Ryan Martin, OrthoCarolina
MD
Robert T. Trousdale, Mayo Clinic Department of Orthopaedic Surgery Rochester,
MD

References

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.

Published
2017-07-01
How to Cite
Fehring, K. A., Wyles, C. C., Martin, J. R., & Trousdale, R. T. (2017). Anterolateral Oblique Distal Femoral Osteotomy for the Removal of Well Fixed Cemented Femoral TKA Components. Reconstructive Review, 7(2). https://doi.org/10.15438/rr.7.2.168
Section
Case Report