Objective: To explore the surgical experience and technical optimization of mortise and tenon bone grafting in repairing tibial defect in severe knee osteoarthritis. Methods: A total of 50 patients of the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology with tibial plateau defect for severe knee osteoarthritis were repaired by mortise and tenon bone graft. Results: All surgeries successfully completed without serious complications. All patients were followed-up for 6 months to 11 years, with an average follow-up of 9.3 years. The postoperative KSS score was 84-92, with an average of 88 scores, which was significantly improved compared with that before surgery. Good knee range of motion were found in all patients at the last follow-up. In the last follow-up, the imaging results showed that defects of the tibial plateau bone were effectively repaired, the knee prosthesis was in good position and of reliable bearing function, and all the bone grafts were completely fused with the tibia without bone resorption, osteonecrosis or other complications. In the last follow-up, for patients with large defects of the tibial plateau, the defect of the tibial plateau was repaired by increasing the osteotomy angle combined with pressure bone grafting, and the transplanted autogenous bone in all patients was completely integrated into the host bone without any clinical symptoms. Conclusion: Mortise and tenon bone grafting in repairing tibial plateau defect for severe knee osteoarthritis is more compact and stable in the early stage. By further improving the surgical details, the contact gap between bone fragments and main bone is smaller and the scope of adaptation is wider, which is a good surgical method and worthy of promotion.
BU Qingxu
,
DONG Lele
. Experience in repairing tibial defect with mortise and tenon bone grafting for severe knee osteoarthritis[J]. Journal of Baotou Medical College, 2024
, 40(10)
: 38
-42
.
DOI: 10.16833/j.cnki.jbmc.2024.10.008
[1] 董乐乐, 樊建军, 蔚磊, 等. 自体楔形骨块修复初次膝关节置换时严重膝内翻畸形的研究[J]. 实用医学杂志, 2015, 31(18): 3046-3049.
[2] 危小东, 陈永岗, 刘佳, 等. 全膝关节置换术中胫骨平台骨缺损的最新处理进展[J]. 实用骨科杂志, 2016, 22(12): 1100-1103.
[3] Demey G, Servien E, Lustig S, et al. Cemented versus uncemented femoral components in total knee arthroplasty[J]. Knee Surg Sports Traumatol Arthrosc, 2011, 19(7): 1053-1059.
[4] Li HQ, Li PC, Wei XC, et al. Effectiveness of antibiotics loaded bone cement in primary total knee arthroplasty: a systematic review and meta-analysis[J]. Orthop Traumatol Surg Res, 2022, 108(5): 103295.
[5] Birkeland ?, Espehaug B, Havelin LI, et al. Bone cement product and failure in total knee arthroplasty[J]. Acta Orthop, 2017, 88(1): 75-81.
[6] Sheth NP, Bonadio MB, Demange MK. Bone loss in revision total knee arthroplasty: evaluation and management[J]. Am Acad Orthop Surg, 2017, 25(5): 348-357.
[7] Dorr LD, Ranawat CS, Sculco TA, et al. Bone graft for tibial defects in total knee arthroplasty[J]. Clin Orthop Relat Res, 1986, (205): 153-165.
[8] Torle J, Thillemann JK, Petersen ET, et al. Less polyethylene wear in monobloc compared to modular ultra-high-molecular-weight-polyethylene inlays in hybrid total knee arthroplasty: a 5-year randomized radiostereometry study[J]. Knee, 2021, 29: 486-499.
[9] Kim EG, Patel NK, Chughtai M, et al. Tantalum cones in revision total knee arthroplasty[J]. Knee Surg, 2016, 29(8): 621-626.
[10] Scuderi GR, Insall JN, Haas SB, et al. Inlay autogeneic bone grafting of tibial defects in primary total knee arthroplasty[J]. Clin Orthop Relat Res, 1989, (248): 93-97.
[11] Rodríguez-Merchán EC, Gómez-Cardero P, Encinas-Ullán CA. Management of bone loss in revision total knee arthroplasty: therapeutic options and results[J]. EFORT Open Rev, 2021, 6(11): 1073-1086.
[12] 蔡谞, 王岩, 王继芳, 等. 自体打压植骨修复膝关节置换术中胫骨平台骨缺损[J]. 中华医学杂志, 2008, (41): 2907-2911.
