Bone loss around the knee in the setting of total knee arthroplasty remains a difficult and challenging problem for orthopaedic surgeons. There are a number of options for dealing with smaller and contained bone loss; however, massive segmental bone loss has fewer options. Small, contained defects can be treated with cement, morselized autograft/allograft or metal augments. Segmental bone loss cannot be dealt with through simple addition of cement, morselized autograft/allograft, or metal augments. For younger or higher demand patients, the use of allograft is a good option as it provides a durable construct with high rates of union while restoring bone stock for future revisions. Older patients, or those who are low demand, may be better candidates for a tumour prosthesis, which provides immediate ability to weight bear and mobilize.
Kuchinad, R. A., Garbedian, S., Rogers, B. A., Backstein, D., Safir, O., & Gross, A. E. (2011). The Use of Structural Allograft in Primary and Revision Knee Arthroplasty with Bone Loss. Advances in Orthopedics, 2011, 1–8. https://doi.org/10.4061/2011/578952