Костная аутопластика дефектов большеберцовой кости при эндопротезировании коленного сустава

Abstract

Objective: to study the results of total knee arthroplasty in the presence of tibial bone defect plateau using an original technique of bone autoplasty. Methods. The analysis of the results of treatment of 12 patients (7 women, 5 men). In 7 patients, primary gonarthrosis was diagnosed, in 2 – post-traumatic, in 3 – secondary arthrosis on the background of rheumatoid arthritis (RA). All patients, due to the presence of tibial condyle defects, underwent bone autoplasty using an original technique. The average defect depth was 13.1±5.2 mm (from 7 to 20 mm), width – 14.2±4.3 mm (from 10 to 22 mm). The observation period was 40±24 months (from 28 to 60 months). The average duration of the operation was 115.7±13.2 minutes (from 90 to 127 minutes). Results. Functional assessment according to the Knee Society Scores (KSS) questionnaire: 6 patients obtained excellent results, 4 – good, 2 – satisfactory (patients with RA). No infectious and thromboembolic complications were recorded. According to X-ray data, there were no signs of instability of the endoprosthesis components. No infectious and thromboembolic complications were recorded. According to the X-ray data, no signs of instability of the components of the endoprosthesis were revealed. Conclusions. Bone autoplasty with resected tibial condyles makes it possible to restore defects up to 20 mm deep. The use of autologous bone reduces the likelihood of allergic reactions, increases the chances of a complete restructuring of the graft and restoration of the supporting surface. The original technique of bone autoplasty provides stable fixation of the graft until its consolidation without additional fixation with metal structures.