关键词: 关节成形术;膝；胫骨；骨缺损;植骨

Abstract:

Objective   To evaluate the therapeutic effect of mixed bone  autograft on Rand C proximal tibial defect in primary total knee arthroplasty (TKA). Methods   We retrospectively analyzed the data of patients from Feb. 2002 to Jun. 2007. 12 cases (male /female: 3/9), totally 16 knees with Rand C proximal tibial bone defect were handled with granular bone autograft combining with structural bone autograft by the same surgeon. The age of the subjects ranged from 50 to 79 (average 63.4). 11 cases (14 knees) suffered from osteoarthritis, and 1 case (2 knees) suffered from rheumatoid arthritis. The follow-up periods ranged from 12 to 48 months, averaged 26.8 months. Preoperative and postoperative X-ray and HSS score 3 days, 3 months, 12 months before and after surgery, and the latest follow-up were recorded respectively. Results   HSS score was promoted from preoperatively 22.5 (19 to 31) to 87 (78 to 96) points in latest follow-up, which has significantly difference (P<0.05), with 4 cases (6 knees) falling into excellent (≥90 points), 7 cases (9 knees) filling into good (80-89), and 1 case(1 knees) moderate (70-79). The excellent and good proportion could reach 93.75%. According to the Xray follow-up, no case was found failed to heal, and no grafts mobilization, bone absorption, bone dissolution, tibial plateau collapse and infection was detected. Although 2 knees were detected out with translucid bands(<1mm), loosening was negative. Conclusion   Autologous combined bone grafting is an effective procedure for treating Rand C proximal tibial bone defect in primary TKA, which could provide primary stability and result in good outcome. 

Key words: Arthroplasty; Knee; Tibia; Bone defect; Bone autograft