Structural Bone Grafting Technique in Total Knee Replacement Surgery

Abstract

There are several options when dealing with bone deficiency in total knee reconstructions. Cement used by itself is inadequate for structural weight-bearing defects that are more than 1cm in depth. Cement, reinforced by screws, can be used to fill small defects in elderly patients. There is a definite place for wedges and revision components. Small contained defects can be filled with morsellised autograft or allograft bone, but for major bone loss I prefer structural weight-bearing bone grafts. The advantages of such grafts are that the bone architecture can be re-established and provides more bone stock for subsequent revisions, if these are necessary. If cement is used, the interface between the components and the graft is inert, at least initially.