Abstract
Abstract. Introduction There are several options of fixation and plasty for tibial defects. Screw and cement augmentation of the tibia is an alternative to conventional bone autograft and allograft. Although use of metal and cement augments provides reliable support for the tibial plateau and facilitates early weight-bearing on the operated limb the technique fails to maintain enough bone stock for future revisions. The purpose was to present an option of cement and metal augmentation of the tibial component in total knee arthroplasty (TKA). Material and methods The technique consists of cement and screw augmentation using three screws placed vertically as a regular triangle and being perpendicular to the tibial plateau. We describe the technique and a clinical instance of type 2A defect of the proximal tibia using the author's method. Outcome measures were goniometry and radiography. Results Goniometry examination showed positive dynamics in the first week after surgery with flexion of 110.0 degrees, extension 175.0 degrees; at 12 months with flexion of 90.0 degrees and extension of 180.0 degrees. Radiographic examination demonstrated no instability and micromobility of the cement mantle. Discussion The author's technique of screw and cement augmentation of the tibial component was practical for type 2A defects of the proximal tibia with a shortage of materials of bone autografts. This is a pilot study that requires further investigations.
Highlights
There are several options of fixation and plasty for tibial defects
Primary arthroplasty of the knee joint is performed at the terminal stages of osteoarthritis which is characterized by the presence of possible defects in the cartilaginous layer and in the subchondral bone
Auto- and alloplasty with bone tissue are considered conventional to fill in defects and ensure the correct position of the tibial plateau, and preserve bone tissue for future revision interventions
Summary
There are several options of fixation and plasty for tibial defects. Screw and cement augmentation of the tibia is an alternative to conventional bone autograft and allograft. The purpose was to present an option of cement and metal augmentation of the tibial component in total knee arthroplasty (TKA). A number of situations arise when the defect depth is greater than the maximum cut volume In this case, extended destruction of bone tissue causes difficulties in fixation of the tibial component in knee arthroplasty. Auto- and alloplasty with bone tissue are considered conventional to fill in defects and ensure the correct position of the tibial plateau, and preserve bone tissue for future revision interventions. These methods do not allow early weight bearing and delay rehabilitation. Purpose of the study To present a variant of tibial plateau plasty in knee arthroplasty
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