Substitution of tibial bony defects with allogeneic and autogeneic cancellous bone: encouraging preliminary results in 18 knee replacements.

Eighteen knee replacements in 15 patients with severe gonarthritis or loosening of total knee arthroplasty (TKA) requiring bone grafting for bony deficiencies were studied before and after operation. The average follow-up was 2.4 years. Fifteen knees showed satisfactory clinical and radiographic results of the integration of the bone grafts. The Hospital for Special Surgery knee score improved from an average of 39 points preoperatively to 83 points at the most recent follow-up examination. Two of 3 knees with loosening of the tibial component required revision. These results are encouraging. Success depends as much on rigid fixation of the grafted bone and protected weight-bearing as on rigid, micromotion-preventing fixation of the tibial component.