DOS 2018

86 · DOS Abstracts CUSTOM MADE POLYETHYLENE LINER TO CORRECT TIBIAL COMPONENT MALALIGNMENT IN A CASE WITH PROXIMAL TIBIAL DEFORMITY. Kappel Andreas, Blom Claes Sjørslev, El-Galaly Anders Aalborg, Aalborg University Hospital Background: TKA revision can be challenging in cases with bony deformity that do not allow the use of standard revision implants. Purpose / Aim of Study: To present the use of an asymmetrical custom made liner in the revision of a case with isolated tibial malpositioning and tibial defor- mity. Materials and Methods: Case story: 54-year-old woman with complaints of instability and malalignment from her right total knee arthroplasty (TKA). Previous surgeries included proximal tibial osteotomy to correct recurvatum fol- lowing a midshaft tibial fracture, primary TKA and a femoral revision. Clinical examination revealed excessive valgus, unaffected range of motion (ROM), moderate soft-tissue laxity and a well-aligned foot. Radiographs, CT and EOS showed coronal malpositioning of the tibial component and sagittal tibial defor- mity, no signs of component loosening or malrotation, valgus angle of 9 degrees. Revision of the malpositioned tibial component was planned, but templating re- vealed that none of the available standard implants would fit the sagittal bony deformity. A custom-made polyethylene was designed with a medial build up to correct varus and a slight posterior build up to correct excessive slope of the tibial component. Revision surgery was uneventful, following moderate medial release the liner was inserted and both alignment and stability was found sat- isfying. Findings / Results: At short time follow up the patient is relived from her com- plaints, both ROM, alignment and stability is clinically satisfying. Postoperative EOS- scan shows 1 degree of valgus. Conclusions: The use of custom-made liner might be an alternative to tibial component revision in cases with isolated tibial mal-positioning and well fixed component. Longevity can be a concern due to asymmetric stresses on both tibial bony fixation and locking mechanism. 27.