[Primary total knee arthroplasty with structural autologous bone grafting of medial tibial condyle defect in elderly patients: a preliminary report].

AIM OF THE STUDY

The aim of the study is to assess the early results of primary total knee arthroplasty with reconstruction of medial tibial condyle with autogenous bone grafting in elderly patients.

MATERIALS AND METHODS

The study was conducted on patients treated with primary total knee arthroplasty. Eight subjects (eight knees) aged 63-82 (mean, 73) with mean varus alignment 18 degress (range, 10-30 degrees) required restoration of medial tibial condyle. Autogenous bone grafting from resected joint ends was used and stabilized with cancellous screws. Patients were surveyed pre- and postoperatively with questionnaires, such as: Knee Injury and Osteoarthritis Outcome Study (KOOS) and SF-36 Health Survey, version 2. Incorporation of the bone graft were evaluated in radiographs. Subsequent folow-up assessments were performed 3, 6 and 12 months after surgery.

RESULTS

Postoperatively, mean range of motion in the knee joint improved from 99 to 124 degrees and pain relief was observed. The largest improvement in KOOS and SF-36 scores was seen for activities of daily living, pain, quality of life and physical functioning, bodily pain domains, respectively. The analysis of radiographs showed incorporation of the bone grafts with no lysis. There was no evidence of graft collapse or tibial component loosening.

CONCLUSIONS

Autogenous bone grafting is valuable material to fill defects in the proximal tibial plateau. Volume of resected grafts and incorporation time are limitations for this technique. On the basis of our observations, we presume that this method is effective in elderly patients.