Autogenous bone grafting for severe angular deformity in total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Reconstructive Surgery

Background:

• Severe angular knee deformities present significant challenges in total knee arthroplasty.
• Defects in the proximal tibia often require bone grafting for structural integrity.
• Autogenous bone grafts offer a biological solution for tibial reconstruction.

Purpose of the Study:

• To evaluate the efficacy of autogenous bone grafting for tibial reconstruction in total knee arthroplasty for severe angular deformities.
• To assess the clinical and radiographic outcomes of this reconstructive technique.
• To analyze graft consolidation and implant stability.

Main Methods:

• Fourteen patients with severe angular knee deformities underwent total knee arthroplasty with autogenous bone grafting to the tibia.
• Bone grafts were harvested from resected distal femur and secured with screw fixation.
• Patients received either Insall-Burstein posterior stabilized or Total Condylar III implants.
• Postoperative follow-up averaged 4.1 years, including clinical assessment and radiographic analysis.

Main Results:

• All bone grafts consolidated successfully without collapse, resorption, or subsidence.
• No change in knee or component alignment was observed postoperatively.
• Patients achieved good or excellent clinical results (Hospital for Special Surgery Knee Rating Scale).
• Average postoperative range of motion improved to 90 degrees.

Conclusions:

• Autogenous bone grafting is a reliable method for reconstructing the proximal tibia in total knee arthroplasty for severe deformities.
• The technique ensures stable graft incorporation and supports prosthetic components.
• This approach leads to favorable clinical outcomes and improved knee function.