[Total knee replacement in joints with severe varus and bone deficiency].

Abstract

Introduction: Total knee replacement in knees with severe valgus and defects of the medial tibial condyle are at higher risk complications than in knees with a correct axial allignement.

Material and methods: The study group included 10 patients (11 knees) with with severe valgus and defects of the medial tibial condyle in which TKR was performed. In 8 cases bone defects were filled with bone autograft in 3 cases defects were filled with metal augments. The mean follow-up was 37 months (26 months to 4 years). Clinical results were measured with the knee society score, the level of activity was evaluated with the UCLA score. Radiographic evaluation was based on radiograms taken preoperatively, postoperatively and at the follow-up examination.

Results: In All cases an improvement in clinical results was noted, the mean KSS result rised from 25.3 preoperatively to 87 postoperatively and the level of activity rised from 3.4 to 5.4 postoperatively. No signs of loosening were found in radiographic evaluation.

Conclusions: TKR in joint with severe varus and medial tibial condyle defects creates a need for the reconstruction of defects. In lesser defects reconstruction with bone autografts is sufficient, in severe cases filling the defect with metal augments is needed. When indicitions are followed both methods provide good clinical results.