Autologous Bone Graft for Tibial Defects on Knee Total Arthroplasty

Osteoarthrosic knees with large bone defects usually develop as varus or valgus deformities, with daily functional disabilities such as pain, instability and limping. Between March 1996 and January 2003, 19 knees of 18 patients were treated through primary total knee arthroplasty using autologous bone graft using the Sculco modified technique to correct large tibial defects. Sixteen knees were assigned to group II and three to group III, according to the classification used in our medical service. Post-operative followup period ranged from eight to 82 months, with an average of 53.73±23.43 months. Postoperative outcomes were similar to those of the primary arthroplasties, with early bone graft incorporation, within an average of 7.58±1.87 months. Collapse was seen in one knee during bone remodeling stage, without infection. The range of motion was between 90o and 125o, with an average of 105.27o±9.47o and the femoral tibial angle was between 170o and 180o, with an average of 175.33o±2.57o. Valgus angle ranging from 3o to 8o was obtained in 73% of the treated knees. The purpose of this study is to assess the effectiveness of the Sculco modified technique in correcting large tibial defects with autologous bone graft through clinical and radiographic observation.