The treatment of bone defects in primary arthroplasty of the knee

The authors reviewed the literature as well as their own cases in order to discuss the indications, advantages and disadvantages relative to the methods used to treat bone defects in primary knee arthroplasty. An analysis shows that the use of cement represents the most unfavorable method from a mechanical point of view and it should thus be limited to defects that are not too deep and extensive. Bone grafts, both homoplastic and autoplastic, are preferred in younger patients. The former in lesions that are smaller, the latter in those that are larger. Currently, modular prostheses are diffusedly used because of their versatility and relatively low cost if we compare them with prostheses that are custom made. Finally, the authors emphasize the need to use intramedullary stems in bone defect with the purpose of reducing stress in the metaphyseal region.