Impacted cancellous autograft for contained bone defects in total knee arthroplasty

Techniques of bone grafting for peripheral tibial defects in total knee arthroplasty are well described using solid bone graft or metal wedges. Central contained defects may be irregularly shaped and not easily managed with bulk grafts or wedges. Morselized grafts loosely packed into the defect may allow cement to intrude into the interstices between the graft fragments. However, impaction of the morselized autograft into a contained defect can permit complete filling of the area with graft and prevent undesirable cement intrusion. This article describes the successful use of this technique in eight patients who underwent primary total knee arthroplasty.