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J Arthroplasty. 2010 Apr;25(3):497.e1-5. doi: 10.1016/j.arth.2009.02.020. Epub 2009 Apr 9.

Tibia pain at end of stem with stemmed revision total knee arthroplasty: treatment with cortical strut graft technique.

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  • 1St Vincent Mercy Medical Center/Ohio University (OUCOM), Toledo, Ohio, USA.


End-of-stem pain related to stemmed revision total knee arthroplasty has been described in the literature as being caused by the elastic modulus mismatch from the stem tip and the native bone. This phenomenon has also been described after total hip arthroplasty, which can be successfully treated by placement of a cabled cortical strut graft at the tip of the femoral stem. Currently, the treatment option for this tibial-sided end-of-stem pain is a re-revision total knee arthroplasty in attempts of alleviating the modulus mismatch. This case report is the first to describe a cabled cortical strut graft technique for the tibial end-of-stem pain associated with stemmed revision total knee arthroplasty.

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