**6. References**


These first test results demonstrate differences between two different states of fixation of both the femoral component and a prototype for latter animal experiments. Hence, this confirms the potential usability of the novel non-invasive approach for detecting implant loosening. In further tests, the influence of the femur-tibia and the femur-pelvis connection has to be investigated. Additionally, the femoral component will be integrated in a human cadaveric femur and measured with defined loosening zones. Moreover, the oscillators could be used in animal studies in order to determine the quality of osseointegration e.g. of

In loosening diagnostics of THR using imaging, an accuracy of 100 % is currently not available. This fact raises the demand for a new system to diagnose loosening exactly. Different approaches have been taken into consideration. Vibrometry, where accelerometers are used to detect resonance frequencies in vivo, seems to be a promising approach. Due to the disadvantage of the excitation with an electrodynamic shaker, we proposed a small mechanical oscillator as novel excitation approach for vibrometry. In the experiments with a Zweymueller femoral component a higher dampening coefficient could be identified in case of a fixed implant. Furthermore, within in vitro experiments using an implant inserted in the

This research project was funded by the Deutsche Forschungsgemeinschaft (DFG - German

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**4. Conclusion** 

**5. Acknowledgment** 

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**18** 

*Italy* 

**Management of Bone Loss in Primary and** 

Total knee arthroplasty (TKA) often deal with bone defect localized in areas corresponding to tibial and femoral articular surfaces, a condition that is often observed in revision knee prosthetic surgery but occasionally in primary arthroplasty of the knee too. Such intraoperative situation, could create a main problem in maintaining proper alignment of the implant components and in establishing sufficient bone stock to achieve a stable boneimplant interface. The surgeon must assess the degree of complexity preoperatively and

Multiple surgical options are available to repair or reconstruct the loss of bone, these

Principles to consider in bone loss management are knee-related (particularly defect size and location, ligament stability, limb alignment) and patient-related (age, body mass index,

Bone loss observed during primary arthroplasty of the knee is less frequent than during

However final cause is always represented by bone erosion, secondary to varus or valgus deformity of the knee; the consequent overload of medial or lateral compartment bring to

Typically, in varus knee bone defect contribute to collapse of the medial tibial plateau, firstly in the posteromedial site. Instead, in valgus knee, bone defect may involve the tibia (with a

intraoperatively and have a broad armamentarium available during surgery.

revision surgery. In primary implants causes of bone defect include:

Sequelae of fracture of tibial plateau or femoral condyles;

collapse of the subchondral bone (Tigani et al., 2004).

include: bone cement, bone grafts, metal augments and custom-made implants.

**1. Introduction** 

activity level, life expectancy).

 Previous tibial osteotomies; Inflammatory arthropathies.

**2. Primary TKA** 

Osteonecrosis;

Bone cysts;

**Revision Knee Replacement Surgery** 

Matteo Fosco1, Rida Ben Ayad1, Luca Amendola1,

*1First Ward of Orthopaedic Surgery, University of Bologna,* 

Dante Dallari1 and Domenico Tigani2

 *Rizzoli Orthopaedic Institute, Bologna 2Department of Orthopaedic Surgery, Santa Maria alle Scotte Hospital ,Siena* 

