{Reference Type}: Journal Article
{Title}: Autogenous structural bone graft reconstruction of ≥ 10-mm-deep uncontained medial proximal tibial defects in primary total knee arthroplasty.
{Author}: Dewidar AA;Mesregah MK;Mesriga MM;El-Behiry AM;
{Journal}: J Orthop Traumatol
{Volume}: 25
{Issue}: 1
{Year}: 2024 Apr 23
{Factor}: 4.239
{DOI}: 10.1186/s10195-024-00762-6
{Abstract}: <B>BACKGROUND: </B>Management of uncontained medial proximal tibial defects during primary total knee arthroplasty (TKA) can be challenging, especially for defects ≥ 10 mm in depth. This study sought to assess the outcomes of autogenous structural bone grafts to address these defects.<BR><B>METHODS: </B>In this prospective study, patients with uncontained medial proximal tibial defects ≥ 10 mm in depth undergoing TKA were managed by autogenous structural bone grafts fixed by screws and were followed up for at least 36 months. Patients were followed-up clinically with Knee Society Score (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Additionally, radiological follow-up was done to assess bone graft union and implant stability.<BR><B>RESULTS: </B>The study included 48 patients with a mean age of 69.2 ± 4.5 years. The mean body mass index (BMI) was 31.4 ± 3.7 kg/m2. The mean defect depth was 17 ± 3.6 mm. With a mean follow-up period of 52.2 ± 12.3 months, the median KSS improved significantly from 30 preoperatively to 89, P < 0.001. The median WOMAC score reduced significantly from 85 preoperatively to 30.5, P < 0.001. The mean ROM increased significantly from 73 ± 12.4 preoperatively to 124 ± 8.4 degrees, P < 0.001. The mean graft union time was 4.9 ± 1 months. No significant complications were reported.<BR><B>CONCLUSIONS: </B>Autogenous bone graft reconstruction is a safe and effective method of addressing uncontained medial proximal tibial defects in primary TKA.<BR><B>METHODS: </B>Level IV.