Total knee arthroplasty for post-traumatic proximal tibial bone defect: three cases report

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Reconstructive Surgery

Background:

• Bone stock deficiency poses challenges in primary and revision total knee arthroplasty (TKA).
• Maintaining implant alignment and bone-implant stability is difficult with significant bone loss.
• Various reconstruction techniques exist, including bone cement, augments, custom implants, and bone grafting.

Purpose of the Study:

• To evaluate the short-term efficacy of structural allograft reconstruction for severe segmental tibial bone defects in TKA.
• To assess the functional and radiological outcomes of using massive structural allografts in TKA.

Main Methods:

• Reported are three cases of severe segmental medial tibial plateau defects treated with massive structural allograft reconstruction and primary TKA.
• Bone defects ranged from 27-33 mm, with moderate knee instability.
• Pre- and post-operative Knee Society Scores (AKS) were recorded.

Main Results:

• Significant improvement in AKS scores from pre-operative ranges (30-51) to post-operative (78-85).
• No acute or chronic complications were observed during the follow-up period.
• Radiological examination showed no signs of prosthetic loosening, graft resorption, or poor integration.

Conclusions:

• Massive structural allograft is a successful biological material for restoring hemi-condylar segmental tibial bone defects in TKA.
• This technique effectively restores bone stock and provides a stable bone-implant interface.
• Structural allografts offer advantages like biocompatibility and potential for bone remodeling.