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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(02): 138-146
DOI: 10.1055/s-0040-1713392
Artigo de Atualização
Joelho

Falhas ósseas nas revisões de artroplastia total do joelho

Article in several languages: português | English
Alan de Paula Mozella 
1   Centro de Cirurgia do Joelho, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil
2   Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brasil
,
Hugo Alexandre de Araújo Barros Cobra
1   Centro de Cirurgia do Joelho, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil
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Resumo

O aumento do número de cirurgias de revisão de artroplastia total do joelho tem sido observado nos últimos anos, em todo o mundo, por diversas causas. Nos Estados Unidos, é estimado um aumento de 601% no número de artroplastias totais do joelho entre 2005 e 2030. Dentre os enormes desafios dessa cirurgia complexa, o adequado tratamento dos defeitos ósseos é essencial para a obtenção de resultados satisfatórios e duradouros. O adequado tratamento dos defeitos ósseos objetiva construir uma plataforma de suporte estável e duradoura para a implantação dos componentes protéticos definitivos e, se possível, com recomposição do estoque ósseo. Concomitantemente, possibilita o correto alinhamento dos componentes protéticos e do membro, assim como permite restabelecer a altura da interlinha articular e, dessa forma, restaurar a tensão de partes moles e distribuição de carga ao osso hospedeiro, gerando uma reconstrução articular com boa função, estável e indolor. Diversas são as opções para manejo dessas falhas ósseas, entre elas: cimento ósseo com ou sem reforço com parafusos, aumentos metálicos modulares, enxerto ósseo impactado, enxerto estrutural homólogo e, mais recentemente, cones metafisários de metal trabecular e sleeve metafisário. O objetivo do presente artigo foi reunir informações clássicas e inovações dos principais aspectos relativos ao tratamento das falhas ósseas durante as cirurgias de revisão de artroplastia total do joelho.

Palavras-chave

artroplastia do joelho - defeitos ósseos - enxertos homólogos - revisão


Publication History

Received: 05 January 2020

Accepted: 15 April 2020

Article published online:
25 September 2020

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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