ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #928

 

Autologous Bone Grafting plus Bio-Absorbable Pin Fixation for Medial Tibial Defects in Total Knee Arthroplasty

Shin Kato, MD, PhD, Yokohama, Kanagawa JAPAN
Hiroshi Takagi, MD, PhD, Yokohama, Kanagawa JAPAN
Jun Oike, MD, Yokohama, Kanagawa JAPAN
Takayuki Okumo, MD, PhD, Yokohama, Kanagawa JAPAN
Saki Yagura, MD, Yokohama, Kanagawa JAPAN
Naoki Okuma, MD, Yokohama, Kanagawa JAPAN
Takayuki Koya, MD, PhD, Koto-Ku, Tokyo JAPAN
Fumiyoshi Kawashima, MD, Tokyo JAPAN
Masahiko Maekawa, MD, PhD, Yokohama, Kanagawa JAPAN
Atsushi Sato, MD, PhD, Koto-Ku, Tokyo JAPAN
Soshi Asai, MD, Yokohama, Kanagawa JAPAN

1-30 Fujigaoka, Aoba-ku, Yokohama , Kanagawa , JAPAN

FDA Status Cleared

Summary

Autologous bone grafting plus bio-absorbable pin fixation is a viable option for most medial tibial defects during TKA.

Abstract

Introduction

Many treatment options are available to manage the bone defects of tibia associated with severe varus osteoarthritis in total knee arthroplasty (TKA). One of the treatment option is autologous bone grafting. But sometimes it is difficult to fix the bone to the defects site of tibia. The purpose of this study was to evaluate radiographic features and functional outcomes of autologous bone grafting plus bio-absorbable pin fixation for medial tibial defects of =10 mm depth in TKA.

Materials And Methods

Five patients aged 56 to 77 (mean age 67) years underwent primary TKA were assessed in this study. Diagnosis was 4 osteoarthritis and 1 osteoarthritis complicated by pigmented villonodular synovitis. We used 4 PFC sigma PS and 1 TC3 implant (DePuy Synthes), and stem extension in all TKAs. The autologous bone was used a block of resected cancellous bone that was made by femoral component box. The use of bio-absorbable pin was Super FIXSORB (DePuy Synthes) which constitutes unsintered hydroxyapatite particles/poly l-lactide (u-HA/PLLA) composites. Clinical and radiological evaluation items were followed. Depth and type of medial tibial defects, femoro-tibial angle(FTA), bone union, bone absorption, collapse of grafted bone, range of motion (ROM) and Japanese Orthopedic Association (JOA) Score were evaluated.

Results

The mean follow-up period was 3.6 years. The mean depth of medial tibial defects was a 19.9mm (range 12.5 – 30.4mm) and defects type was asymmetrical loss in all patients. The mean ROM was increased from 107 degrees preoperatively to 116 degrees at the final follow up. The mean JOA score were improved from 51 to 81. The mean FTA was improved from 193 degrees to 180 degrees. The grafted bone completely incorporated into the host bone in all patients. Although partial bone absorption of the grafted bone was noted 3 patients, no collapse of the grafted bone was noted on radiographs.

Conclusion

The advantage of autologous bone grafting plus bio-absorbable pin fixation is high biocompatibility, bone preservation and capable of full weight gait at early postoperative period. Autologous bone grafting plus bio-absorbable pin fixation is a viable option for most medial tibial defects during TKA.