Using allogenous structural bone graft for uncontained tibial bone defects ≥ 10 mm in depth in primary total knee arthroplasty

• Published in: BMC musculoskeletal disorders Vol. 23; no. 1; p. 528
• Main Authors: Iwase, Dai, Metoki, Yukie, Kusumoto, Yasuaki, Aikawa, Jun, Fukushima, Kensuke, Takano, Shotaro, Mukai, Manabu, Uchida, Kentaro, Inoue, Gen, Takaso, Masashi
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02.06.2022; BioMed Central; BMC
• Subjects: Aged; Allogenous structural bone graft; Ankle; Arthroplasty (knee); Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - methods; Bone graft; Bone grafts; Bone Transplantation - methods; Bone-grafting; Defects; Health aspects; Humans; Joint replacement surgery; Knee; Knee Prosthesis; Methods; Musculoskeletal diseases; Nonunion; Orthopedics; Patients; Polymethyl methacrylate; Primary total knee arthroplasty; Prostheses; Radiography; Retrospective Studies; Rheumatoid arthritis; Skin & tissue grafts; Tibia; Tibia - diagnostic imaging; Tibia - surgery; Tibial bone defect; Transplants & implants; Variance analysis; Japan; United States > US; Radiography; Allogenous structural bone graft; Primary total knee arthroplasty; Bone graft; Tibial bone defect
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-022-05491-7

In primary total knee arthroplasty (TKA), tibial bone defects ≥ 10 mm in depth often become uncontained defects, a condition most surgeons find challenging to treat. Although the allogenous bone graft is a useful method, complications such as infection and nonunion are likely to occur. There are several reports on the use of allogenous bone graft in revision TKA; however, few studies have investigated its use in primary TKA. We performed primary TKA using the allogenous bone graft as a structural bone graft to treat uncontained defects ≥ 10 mm in depth. This study aimed to assess the clinical and radiographical results after primary TKA with allogenous structural bone graft (ASBG). Seventeen patients (mean age, 69.2 years) with a follow-up period of at least 7 years, were retrospectively reviewed. All cases had been treated for medial bone defects using the ipsilateral medial tibial allogenous bone. Clinical evaluation included the assessment of the knee and function scores and knee angle, and the hip-knee-ankle (HKA) angle, bone union, and radiolucent line (RL) were assessed radiologically. The mean depth of the medial tibial defects after tibia cutting was 16.8 mm. Nonunion occurred in one case, and RL occurred in another. We observed a significant difference when the preoperative knee score and HKA angle of patients was compared with that at 1 year postoperatively and the final evaluation. No major complications were observed. The ASBG technique produced favorable surgical outcomes and may be an acceptable procedure for managing uncontained tibial bone defects ≥ 10 mm in depth in primary TKA.