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Tissue engineering strategies to construct vascularized bone grafts potentially revolutionize the treatment of massive bone loss.
For example massive bone loss caused by trauma and tumor resection as well as deformities require reconstructive surgery.
The use of a custom triflange is indicated for massive bone loss and discontinuity in which other reconstructive options are not considered suitable.
Options in revision total knee arthroplasty with massive bone loss include arthrodesis, custom total knee arthroplasty, amputation, and revision with structural allograft prosthesis composites.
For extreme circumstances, such as gross instability of the medial collateral ligament, massive bone loss, comminuted fracture, and chronic dysfunction of the extensor mechanism, there is a place for hinged revision implant surgery with good clinical results and quality of life.
But what is the reason for this massive bone loss?
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Open fractures of the tibia accompanied by massive segmental bone loss and critical vascular injury are major treatment challenges.
Acetabular antiprotrusio devices were needed in 13% of patients for Paprosky 3A or B massive acetabular bone loss.
In 1993, a bulk allograft in combination with an acetabular cage and a cemented cup were used to treat the left massive acetabular bone loss.
In the 180 acetabular revision procedures performed in the time period, 24 patients (13 men) met the criteria of massive aseptic acetabular bone loss to warrant this technique.
The use of the Burch-Schneider APC and massive allografts is an effective technique for the reconstructive treatment of extensive acetabular bone loss with long-lasting survival.
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