Union, Knee Alignment, and Clinical Outcomes of Patients Treated With Autologous Bone Grafting for Medial Tibial Defects in Primary Total Knee Arthroplasty.

Autologous bone grafting is an established method to overcome bone deficiencies in primary total knee arthroplasty (TKA). However, recently, metal augments have been used by many surgeons. Although autologous bone grafting is a common technique, few large studies have described its success in achieving bone union in primary TKA. The goal of this study was to evaluate primary TKA with autologous bone grafting for tibial defects. A total of 68 knees that had undergone arthroplasty with autologous bone grafting with more than 1 year of follow-up were evaluated. Average follow-up was 6.6 years (range, 1.2-14.6 years). The autologous bone grafting procedure attached the proximal portion of the tibial resection from the lateral side to the bone graft on the medial side with 2 screws. The prosthesis, which had a standard and nonrevision stem, was implanted with cement. Bone union was assessed with fluoroscopic radiography with a weight-bearing anteroposterior view. The rate of bone union was 97% (65 knees). Correction of preoperative alignment was achieved and maintained until final follow-up. Postoperative knee angle and knee and function scores showed significant improvement. One infection occurred, but there were no local complications, such as backout of screws or collapse of bone grafts. The authors believe that autologous bone graft within TKA is a relatively simple and effective procedure that provides good bone union. [Orthopedics. 2017; 40(4):e604-e608.].