Autogenous Bone Graft with Perpendicular Screw Fixation of the Medial Tibial Bone Defect in Total Knee Arthroplasty

Chun, Churl Hong; Song, Ha Heon; Kim, Yeung Jin; Yang, Hwan Duk

Abstract

PURPOSE
We modified the Scuderi bone graft method for severely varus deformed patients, and then analyzed the clinical and radiological results and the changes of BMD at bone graft site.
MATERIALS AND METHODS
Twenty-three total knee arthroplasties were performed in severely deformed varus knees. The proximal tibia was resected less than 10 mm thickness. In anteroposterior and tibial plateau view, defects was converted into a trapezoidal wedge shape for the self locking, and preserved anterior and posterior cortex. The defect was filled with an autogenous bone graft and fixed with two screws perpendicularly for early ambulation.
RESULTS
The graft was completely united in 21 cases (90%) and the average of the union was 4 months postoperatively. The results were classified as excellent in 16 knees (70%) , good in 6 knees (26%) , and fair 1 knee (4%) using HSS knee rating scale. The average arc of motion was 115. and the tibio-femoral angle was 6.3. valgus. The BMD of bone graft site was checked 1.03 +/- 0.033 g/cm2 postoperatively and converted to 0.82 +/- 0.075 g/cm2 at follow-up 1 year.
CONCLUSION
Modified autogenous bone graft could be preserved the subchondral bone essential for optimal thickness of cement and fixation of the tibial component.