Autologous bone grafting for medial tibial defects in total knee arthroplasty

Seventeen posterior stabilized Insall-Burstein knee arthroplasties were implanted in severely deformed varus knees with large medial tibial bony defects. The defect was filled with an autologous bone graft obtained from the same knee and fixed with one or two screws. The patients were reviewed during an average follow-up period of 4 years (range, 2-8 years). The graft was completely united in 14 cases (82%), with bony trabeculae crossing the interface. Fibrous union occurred in three cases (18%). There was no evidence of graft necrosis or collapse. The results were classified as excellent in 10 knees (59%), good in 6 (35%), and poor in 1 (6%), which was revised for femoral loosening. The importance of meticulous technique and correct component positioning is emphasized.