Management of Tibial Bony defects in Primary complex Total Knee Replacement (TKR) using metal block augments.

Presenting Author - Ashish Singh

Abstract Tibial bony defects are commonly encountered during total knee Replacement has been associated commonly with varus and fixed flexion deformities. Also in this part of the country patients usually present late with severe bony defects especially in tibia and the Total knee Replacements becomes challenging. The defects usually needs augmentation with bone grafts, screws, tibial augments and extension rods or offset stems to have a stable functioning knee replacement procedure. The augmentation of bony defects is crucial to the mentainence of implant stability and alignment and longevity of TKR1, 2 Tibial bony defect has been managed traditionally with bone cementing, insertion of a thick polythethylne implant after bone resection down to bone defect or bone grafting (3). Some recent studies have introduced metal wedge or block augmentation methods 10-12.However there are still controversies over the advantages and disadvantages of these methods .In fact there is a paucity of in the literature on the results of primary TKR with metal block augmentation. This is prospective study conducted at Anup Institute of Orthopaedics and Rehabilitaion, Patna and in the current study we analyzed the indications, clinical and radiolographic results of primary complex TKR which required augmentation with screws, bone grafts, metal augments and tibial extension rods. In addition patient related outcome measures were also assessed and their return to work was also studied. The importance of this study is that surgeries were performed using navigation and the defects, deformity data was analyzed and the correction achieved on table was also recorded.