Augments and Allografts in Revision Total Knee Arthroplasty

Sixty-five consecutive Coordinate (DePuy, Warsaw, Ind) revision total knee arthroplasties were eligible for minimum 5-year follow-up. Nine patients died and 2 patients were lost. Therefore, 54 knees (51 patients) had a known outcome. Nine knees failed and required either revision or component removal. Eight additional knees were considered clinical failures. Despite the use of metallic augmentation in 89% of the knees, large structural allografts were required in 48% of the knees. Revisions with bone loss that required bulk allograft failed less often (19.2%) than revisions managed without bulk allografts (42.9%). Of 24 knees originally revised for osteolysis/polyethylene wear, only 1 required rerevision for the same mechanism of failure. Modular augments did not effectively address the bone loss and instability encountered in many instances at revision surgery. Survivorship of this implant was 79.4% ± 13.7% at 8 years.