Reconstruction of slope bone defects of proximal tibia in total knee arthroplasty
- VernacularTitle:全膝关节置换术中胫骨近端倾斜型骨缺损的重建
- Author:
Houshan LU
;
Dong WANG
- Publication Type:Journal Article
- Keywords:
Arthroplasty, replacement, knee;
Tibia;
Bone remodeling
- From:
Chinese Journal of Orthopaedics
2001;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective Bone defect in proximal tibia was common problem needed to manage in serious genu varum during total knee arthroplasty. In order to introduce measures and experiences to reconstruct slope bone defects in proximal tibia with autograft of tibial plateau in total knee arthroplasty, 29 knees of 22 cases treated in our hospital were reviewed retrospectively. Methods From November 1992 to September 2000, 22 cases with slope bone defects in proximal tibia underwent total knee arthroplasty, there were 5 males with 5 knees and 17 females with 24 knees, the average age of the patients was 61.2 years ranging from 43 to 78 years. The diagnosis of the patients was osteoarthritis in 13 cases (14 knees) which were associated with genu varum in 12 cases (13 knees) and genu valgum in 1 case (1 knee), rheumatoid arthritis in 7 cases (12 knees), synovial chondromatosis in 1 case (1 knee), and Kaschin-Beck disease in 1 case (1 knee). All of the knee prostheses were fixed by antibiotic cement. During operation, the slope bone defect of the proximal tibia was repaired into steping bone defect by osteotomy, and then the defect was restored with the resected tibial plateau autograft. Results Three days after operation, functional excise of the knee was begun, the wound healed in one stage in all the patients. The patients were followed up 1 to 9 years with the average of 4.2 years. Knee pain and deformity of the patients disappeared. The HSS knee score improved from preoperative 10-26 to postoperative 76-94. One patient was revised with ⅠB-Ⅱwedge prosthesis because of late infection, absorption of the autograft bone and loosening of the prosthesis. Nonunion, displacement, bone absorption of the autograft or loosening of the prostheses were not found in the other cases at final follow-up. Conclusion In total knee arthroplasty with slope bone defects in proximal tibia, the autograft of resected tibial plateau may reconstruct its integrity and prevent collapse of the tibia plateau. These procedures will markedly provide the initial stability of the prostheses and improve the success rate of the surgery.
