Biological Reconstruction of Posteromedial Tibial Defect with Autogenous Bone Graft in Complex Knee Arthroplasty

We conducted this study to examine the clinical outcomes of primary total knee arthroplasty (TKA) with autogenous bone graft for a tibial bony defect with a minimum follow-up of 12 months.

A total of 21 individuals underwent primary TKA with autogenous on-lay bone grafting (ABG) for restoration of posteromedial tibial deformities between January 2016 and November 2021. The patients were clinically assessed using the knee society score (KSS), varus score, and range of motion (ROM) preoperatively and postoperatively to compare using a single sample t test. Postoperative complications were also considered.

KSS before and after surgery was reported to be statistically significant [mean difference = -55.32 (6.81); P < 0.001]. The mean KSS before surgery was 21.14 (7.03) while improved to the mean KSS after surgery of 76.45 (3.05). ROM score before and after surgery was reported to be statistically significant [mean difference = -30.45 (8.99); P < 0.001]. The mean ROM before surgery was 75.45 (6.71) while the improved mean ROM after surgery of 105.91 (5.03). Varus score before and after surgery was reported to be statistically significant [mean difference = 18.45 (3.75); P < 0.001].

The mechanical axis and stability of the knee were effectively restored, with significant differences in preoperative and postoperative results, indicating that this technique is a reasonable and versatile option when reconstructing moderate-to-severe bone loss in TKA.