Correction of varus deformity with tibial flip autograft technique in total knee arthroplasty

Franceschina, Michael J.; Swienckowski, John J.

doi:10.1016/s0883-5403(99)90121-3

Cited by 14 publications

(9 citation statements)

References 11 publications

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“…The use of autograft in reconstruction of the knee has been debated. 21 Success has been achieved with smaller bone defects, whether centrally contained [27][28][29] or peripherally uncontained, [29][30][31] although higher rates of failure have been seen in the presence of instability and large bone defects. 32 Structural allograft, typically used for the reconstruction of large defects, has shown variable early results, [33][34][35] with reports of nonunion and collapse of the graft because of resorption.…”

Section: Surgical Optionsmentioning

confidence: 99%

The management of bone loss in revision total knee replacement

Whittaker

Dharmarajan

Toms

2008

The Journal of Bone and Joint Surgery. British volume

111

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The management of bone loss in revision replacement of the knee remains a challenge despite an array of options available to the surgeon. Bone loss may occur as a result of the original disease, the design of the prosthesis, the mechanism of failure or technical error at initial surgery. The aim of revision surgery is to relieve pain and improve function while addressing the mechanism of failure in order to reconstruct a stable platform with transfer of load to the host bone. Methods of reconstruction include the use of cement, modular metal augmentation of prostheses, custom-made, tumour-type or hinged implants and bone grafting. The published results of the surgical techniques are summarised and a guide for the management of bone defects in revision surgery of the knee is presented.

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Section: Surgical Optionsmentioning

confidence: 99%

The management of bone loss in revision total knee replacement

Whittaker

Dharmarajan

Toms

2008

The Journal of Bone and Joint Surgery. British volume

111

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“…There are 5 types of basic reconstruction methods, including tibial component downsizing and resection of uncapped proximal medial bone, the cement-only technique, the screw and cement technique, metal augmentation, and autologous bone grafting [ 5 – 7 , 13 , 25 , 26 ]. Compared to other methods, the screw and bone cement technique has many advantages as follows: (1) compared to the bone cement-only method, the strength of bone cement is greatly enhanced; (2) compared to bone grafting and metal augmentation, the screw and cement technique can simplify the operation, shorten the operative time, decrease the risk of infection, and reduce the use of additional implants; and (3) it is less expensive, and the effect is reliable.…”

Section: Discussionmentioning

confidence: 99%

Finite Element Assessment of the Screw and Cement Technique in Total Knee Arthroplasty

Zheng

et al. 2020

BioMed Research International

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Background. The screw and cement technique is a convenient method used to rebuild medial tibial plateau defects in primary total knee arthroplasty (TKA). The objective of this study was to perform a finite element assessment to determine the effect of different numbers of screws on the stability of TKA and to determine whether differences exist between two different insertion angles. Method. Six tibial finite element models with defects filled with screws and cement and one model with defects filled only with cement were generated. Contact stresses on the surface of cancellous bone in different areas were calculated. Results. Compared to the cement-only technique, the stress on the border of cancellous bone and bone cement decreased by 10% using the screw and cement technique. For bone defects with a 12% defect area and a 12-mm defect depth, the use of 1 screw achieved the greatest stability; for those with a 15% defect area and a 20-mm defect depth, 2 screws achieved the greatest stability. Conclusions. (1) The screw and cement technique is superior to the bone cement-only technique. For tibial defects in which the defect area comprises a large percentage but the depth is less than 5 mm, the screw and cement technique is recommended. (2) Vertical screws can achieve better stability than oblique screws. (3) Screws should be used in moderation for different defects; more is not always better.

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“…It has been reported that iliac crest grafts, femoral and tibia cut autografts were used to biologically reconstruct the tibia medial defect. [ 1 , 2 , 5 , 6 , 18 - 21 ] We used autografts obtained from tibia cuts in the reconstruction of these defects. This was due to the fact that iliac crest graft harvesting causes morbidity in donor site and that proximal tibia cut autograft is more resistant than the femoral condyle cut autografts.…”

Section: Discussionmentioning

confidence: 99%

Using Tibia Proximal Cut Autograft in Advanced Varus Knee Deformity in Total Knee Arthroplasty; Outcomes Compared to the Control Group

Arslan

2018

TOORTHJ

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Background:The purpose of this study was to compare the outcomes of Total Knee Arthroplasty (TKA) performed for advanced varus knee deformity, which is performed by using tibia proximal cut bone for the reconstruction of the tibia proximal medial bone defects, with a control group consisting of TKAs which did not need reconstruction.Methods:Patients in the present study underwent total knee arthroplasty between 2009 and 2015. 12 patients with advanced varus deformity who had undergone reconstruction with tibia proximal cut autograft and 15 patients who were randomly selected from patients who did not need reconstruction, were compared clinically and radiographically.Results:The mean follow-up period of the patients was found to be 73.1 ± 19.7 (36-108) months in the reconstruction group and 73.2 ± 12.3 (39-107) months in the control group. (p> 0.05) In both groups, significant improvement was observed postoperatively. In both groups, there was no evidence of loosening the required revision. WOMAC score was 32.4 ± 13.3 (8-64) in the reconstruction group and 28.9 ± 17.2 (6-70) in the control group at the last control visit. There was no difference between the groups when comparing the WOMAC scores at the last control visit. In the reconstruction group, the Hip-Knee-Ankle (HKA) angle was 26.1 ± 4.9 ° varus preoperatively and 1.3 ± 2.3 ° valgus postoperatively; and in the control group 10.1 ± 2.1 ° varus preoperatively and 2.7 ± 3.4 ° valgus postoperatively. (p> 0.05)Conclusion:In the present study, clinical and radiographic results of total knee arthroplasty patients, who suffered from advanced knee varus deformity and whose proximal tibia medial defects were reconstructed by using tibial proximal cut autograft, have been found to be successful when compared to the control group.

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Correction of varus deformity with tibial flip autograft technique in total knee arthroplasty

Cited by 14 publications

References 11 publications

The management of bone loss in revision total knee replacement

The management of bone loss in revision total knee replacement

Finite Element Assessment of the Screw and Cement Technique in Total Knee Arthroplasty

Using Tibia Proximal Cut Autograft in Advanced Varus Knee Deformity in Total Knee Arthroplasty; Outcomes Compared to the Control Group

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