Tibial Wedge Augmentation for Bone Deficiency in Total Knee Arthroplasty

Abstract

This report constitutes a followup of a previous study of 28 knees in 25 patients with metal wedge augmentation for tibial bone deficiency. Those patients were reviewed 2.3 years after surgery; 79% had excellent results, and 21% had good results. Twenty-four knees in 21 patients with a metal wedge augmentation for tibial bone deficiency were reviewed 5.6 years clinically and 4.8 years radiographically after surgery. Clinical results were excellent in 67%, good in 29%, and poor in 4%. The only poor result was in 1 knee that required 2 revision procedures: the first for failure of a metal-backed patellar component and the second for aseptic loosening of the femoral component. Radiolucent lines at the cement bone interface beneath the metal wedge were present in 13 knees. Eleven of those radiolucencies were < 1 mm in width, and 2 were 1 to 3 mm in width. None of those lucent lines were progressive. Metal wedge augmentation for tibial bone deficiency is a useful option. No deterioration of the wedge-prosthesis or wedge-cement-bone interface was seen at midterm followup.