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Biological Reconstruction of Posteromedial Tibial Defect with Autogenous Bone Graft in Complex Knee Arthroplasty

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Abstract

Purpose

We conducted this study to examine the clinical outcomes of primary total knee arthroplasty (TKA) with autogenous bone graft for a tibial bony defect with a minimum follow-up of 12 months.

Methods

A total of 21 individuals underwent primary TKA with autogenous on-lay bone grafting (ABG) for restoration of posteromedial tibial deformities between January 2016 and November 2021. The patients were clinically assessed using the knee society score (KSS), varus score, and range of motion (ROM) preoperatively and postoperatively to compare using a single sample t test. Postoperative complications were also considered.

Results

KSS before and after surgery was reported to be statistically significant [mean difference = −55.32 (6.81); P < 0.001]. The mean KSS before surgery was 21.14 (7.03) while improved to the mean KSS after surgery of 76.45 (3.05). ROM score before and after surgery was reported to be statistically significant [mean difference = −30.45 (8.99); P < 0.001]. The mean ROM before surgery was 75.45 (6.71) while the improved mean ROM after surgery of 105.91 (5.03). Varus score before and after surgery was reported to be statistically significant [mean difference = 18.45 (3.75); P < 0.001].

Conclusion

The mechanical axis and stability of the knee were effectively restored, with significant differences in preoperative and postoperative results, indicating that this technique is a reasonable and versatile option when reconstructing moderate-to-severe bone loss in TKA.

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Data availability

The authors attest that the publication and its supplemental materials have the data necessary to support the conclusions of this investigation. Data supporting Figures 1, 2 and 3 and Tables 1, 2 not publicly available in order to protect patient privacy. Repository as part of this record included in https://doi.org/10.1007/s43465-023-00857-y.

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Acknowledgements

We would like to acknowledge Dr. Uzair Yaqoob for his final review and critical appraisal of this manuscript.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Orthopedic Department, Dr. Ruth K. M. Pfau Civil Hospital Karachi, Karachi, Pakistan

    Muhammad Waqas Khan & Irfan Muhammad Rajput

  2. Dow Medical, University of Health Sciences, Karachi, Pakistan

    Javeria Qamar

  3. Orthopedic Department, Niazi Medical and Dental College, Lahore Road, Sargodha, Pakistan

    Aurangzeb Qureshi

Authors
  1. Muhammad Waqas Khan
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  2. Irfan Muhammad Rajput
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  3. Javeria Qamar
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  4. Aurangzeb Qureshi
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Contributions

This article was prepared in collaboration between all authors. Authors M.W.K. and I.M.R. did conception and design, acquisition of data, analysis, and interpretation of data. Author M.W.K. drafted the article and did the critical revision. Authors I.M.R., J.Q., and A.Q. did the acquisition of data, analysis, and interpretation of data. All authors gave final approval of the version to be published. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Muhammad Waqas Khan.

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Conflict of Interest

The authors declare that there is no conflict of interest.

Informed Consent

Informed consent was not sought for the present study because this was a retrospective data collection.

Ethical Approval

Ethical approval for this study was obtained from the Orthopedic Department of Dr. Ruth K. M. Pfau, Civil Hospital, Karachi, Pakistan.

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Khan, M.W., Rajput, I.M., Qamar, J. et al. Biological Reconstruction of Posteromedial Tibial Defect with Autogenous Bone Graft in Complex Knee Arthroplasty. JOIO 57, 856–862 (2023). https://doi.org/10.1007/s43465-023-00857-y

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  • DOI: https://doi.org/10.1007/s43465-023-00857-y

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