Use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplasty

Abstract Background The use of autogenous bone graft is a well–known technique for reconstruction of tibial bone defects in primary total knee arthroplasty (TKA). In cases where the size of the bone graft is inappropriate, the stability of bone graft fixation and subsequent bone graft to host bone i...

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Main Authors: Jung-Ro Yoon, In-Wook Seo, Young-Soo Shin
Format: Article
Language:English
Published: BMC 2017-11-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12891-017-1826-4
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author Jung-Ro Yoon
In-Wook Seo
Young-Soo Shin
author_facet Jung-Ro Yoon
In-Wook Seo
Young-Soo Shin
author_sort Jung-Ro Yoon
collection DOAJ
description Abstract Background The use of autogenous bone graft is a well–known technique for reconstruction of tibial bone defects in primary total knee arthroplasty (TKA). In cases where the size of the bone graft is inappropriate, the stability of bone graft fixation and subsequent bone graft to host bone incorporation may be compromised. We describe a simple and reliable technique of reconstruction in a proximal tibia bone defect at the time of primary TKA by using autogenous onlay bone graft (AOBG). Methods Records were reviewed of 19 patients (mean age, 72 years) who underwent primary TKA using AOBG without the additional allogenous bone or metal augments, between August 2013 and August 2014. Results Mean Knee Society score (KSS) in the 22 knees was significantly higher postoperatively than preoperatively (92 ± 4 vs. 30 ± 7, P < 0.001). The mean range of motion (ROM) in the 22 knees, which was 106 ± 12° preoperatively, improved to 112 ± 10° at last follow-up, but this this difference was not significant (P = 0.32). No migration of implants and presence of radiolucent lines at the bone cement-prosthesis interface were observed. Furthermore, the serial radiographs of 19 patients had a mean time of 3.2 months (range, 2.7–4.4 months) for solid union with cross trabeculation between the proximal tibial bone and graft. Conclusions This simple AOBG supplement technique may biologically promote graft to host bone healing by enhancing fixation stability without the additional fixatives and assist the surgeon in managing the varying nature of uncontained bone defects. Trial registration Trial registration number: KCT0002328, May 15, 2017.
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spelling doaj.art-e4d9445e38f1489ca4fa2c344d01b7842022-12-21T17:57:22ZengBMCBMC Musculoskeletal Disorders1471-24742017-11-011811710.1186/s12891-017-1826-4Use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplastyJung-Ro Yoon0In-Wook Seo1Young-Soo Shin2Department of Orthopedic Surgery, Veterans Health Service Medical CenterDepartment of Orthopedic Surgery, Veterans Health Service Medical CenterDepartment of Orthopedic Surgery, Veterans Health Service Medical CenterAbstract Background The use of autogenous bone graft is a well–known technique for reconstruction of tibial bone defects in primary total knee arthroplasty (TKA). In cases where the size of the bone graft is inappropriate, the stability of bone graft fixation and subsequent bone graft to host bone incorporation may be compromised. We describe a simple and reliable technique of reconstruction in a proximal tibia bone defect at the time of primary TKA by using autogenous onlay bone graft (AOBG). Methods Records were reviewed of 19 patients (mean age, 72 years) who underwent primary TKA using AOBG without the additional allogenous bone or metal augments, between August 2013 and August 2014. Results Mean Knee Society score (KSS) in the 22 knees was significantly higher postoperatively than preoperatively (92 ± 4 vs. 30 ± 7, P < 0.001). The mean range of motion (ROM) in the 22 knees, which was 106 ± 12° preoperatively, improved to 112 ± 10° at last follow-up, but this this difference was not significant (P = 0.32). No migration of implants and presence of radiolucent lines at the bone cement-prosthesis interface were observed. Furthermore, the serial radiographs of 19 patients had a mean time of 3.2 months (range, 2.7–4.4 months) for solid union with cross trabeculation between the proximal tibial bone and graft. Conclusions This simple AOBG supplement technique may biologically promote graft to host bone healing by enhancing fixation stability without the additional fixatives and assist the surgeon in managing the varying nature of uncontained bone defects. Trial registration Trial registration number: KCT0002328, May 15, 2017.http://link.springer.com/article/10.1186/s12891-017-1826-4Bone defectBone graftKnee reconstructionKnee replacement
spellingShingle Jung-Ro Yoon
In-Wook Seo
Young-Soo Shin
Use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplasty
BMC Musculoskeletal Disorders
Bone defect
Bone graft
Knee reconstruction
Knee replacement
title Use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplasty
title_full Use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplasty
title_fullStr Use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplasty
title_full_unstemmed Use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplasty
title_short Use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplasty
title_sort use of autogenous onlay bone graft for uncontained tibial bone defects in primary total knee arthroplasty
topic Bone defect
Bone graft
Knee reconstruction
Knee replacement
url http://link.springer.com/article/10.1186/s12891-017-1826-4
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