Autologous bone grafting plus screw fixation for medial tibial defects in total knee arthroplasty

To investigate the efficacy of autologous bone grafting plus screw fixation to reconstruct the medial tibial defects in total knee arthroplasty (TKA). From November 2001 to November 2004, 46 patients (50 knees) with medial tibial bone defects underwent TKA at our hospital. There were 16 males (16 knees) and 30 females (34 knees). They included osteoarthritis (OA) (n = 35, 38 knees) and rheumatoid arthritis (RA) (n = 11, 12 knees). A total of 46 patients underwent three-dimensional CT (computed tomography) reconstruction to evaluate the tibial plateau defects after osteotomy. Single or double distal femoral osteotomic bone was used to reconstruct the bone defects with the hollow nail internal fixation. Another 80 TKA patients (86 knees) were randomly selected as the control group. The surgical outcome, lateral migration of tibial component and joint line elevation, etc. were analyzed and the follow-up knee society scores recorded. The patients were followed up for 6 to 9 years. Two patients were lost to follow