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KMID : 0361620170520060514
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Journal of the Korean Orthopaedic Association
2017 Volume.52 No. 6 p.514 ~ p.520
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The Effects of Autologous Structural Bone Graft without Internal Fixation on Posteromedial Tibial Bone Defect in Primary Total Knee Arthroplasty
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Chon Je-Gyun
Song In-Soo
Kim Jun-Beom
Jang Gun-Il
Ahn Chi-Hoon
Yoon Ja-Young
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Abstract
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Purpose: To evaluate the radiological and clinical outcomes of the standard total knee arthroplasty without internal fixation or extended long stem in tibial bone defect with severe varus deformity.
Materials and Methods: Between July 2012 and April 2014, 32 patients (45 cases; 4 men and 41 women with a mean age of 74.2 years) who underwent total knee arthroplasty with autologous bone grafting were enrolled for analysis. The mean follow-up period was 34.4 months. The cancellous bone defect site was exposed, and a longitudinal sulcus was made. Subsequently, a premolded bone graft was inserted in the sulcus at 45°. The defect size was measured, and the radiological and clinical results were evaluated.
Results: The mean defect size according to the radiograph was found to be 15.31×30.36 mm in the frontal view and 15.46×45.98 mm in the sagittal view. The mean defect size of depth during the operation was found to be 8.38 mm. The preoperative mean varus angle was 14.1° (4.0°?26.9°), and the follow-up mean valgus angle was 5.4° (0.5°?10.5°). The implant position was α=95.7°, β=90.4°, γ=2.1°, δ=89.1° on the follow-up. No implant loosening was observed, and the mean bone union period was 4.3 months. The Hospital for Special Surgery score was improved from a preoperative mean of 50.1 to a postoperative mean of 90.4.
Conclusion: Standard total knee arthroplasty using autologous structural bone grafting without internal fixation in a tibial bone defect demonstrated a rapid, stable bone healing and excellent radiological and clinical results. Thus the index procedure was considered to be simple, and effective for bone grafting.
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KEYWORD
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knee arthroplasty, bone grafting
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