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Click here to access this Full-length streaming video Unicondylar Osteoarticular Allografts of the Knee
Luis D. Muscolo, MD and Miguel A. Ayerza, MD
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Surgical resection is the primary treatment goal in aggressive benign and malignant bone tumors, often creating large osseous defects. Unicondylar osteoarticular defects of the knee are challenging because of the demands of stability and function of this weight-bearing joint. Currently, functional reconstructive options for these defects include structural allograft transplantation, endoprosthetic replacement, and composite reconstruction with use of allografts and metal prostheses. Prosthetic and composite reconstructions require sacrificing the uninvolved condyle and the contralateral side of the joint. Bicondylar osteoarticular allografts provide the opportunity to support mechanical loads, and attach host ligaments and muscles to the allograft, but this approach compromises both knee condyles in circumstances in which only one condyle is involved by the tumor. For these reasons, unicondylar osteoarticular allografts may be a more acceptable option.
The surgical technique of unicondylar osteoarticular allograft reconstruction is demanding. However, preserving the uninvolved condyle may substantially improve the biomechanics of the reconstruction. In this JBJS/VJO video supplement to the article, Muscolo et.al. discuss and demonstrate this demanding surgical technique.
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