Anterior Distal Femoral Osteotomy for Removal of Long Femoral Stems in Revision Knee Arthroplasty

摘要

Proximal femoral osteotomies for revision of hip arthroplasty [1,2] and tibial tubercle osteotomy [2-5] for revision of knee arthroplasty have been extensively discussed in the literature. Conversely, distal anterior femoral osteotomy for revision knee arthroplasty is only briefly mentioned [2-4]. The largest report on this technique included only 4 patients by Massin et al in 2012 and the technique was not clearly outlined [5].We describe our method of anterior distal femoral osteotomy to address revision of well-fixed, fully cemented or porous long stems on femoral components of knee arthroplasty. The technique permits complete visualization of the femoral canal and is particularly valuable in the setting of explantation for infection, in which complete removal of implants, cement mantle, and canal restrictors along with thorough debridement is required. It permits the preservation of soft tissue attachments to maintain the viability of the anterior cortical bone fragment.