Bone Grafting in Primary and Revision Total Knee Arthroplasty

Abstract

When severe malalignment occurs in destructive knee joint disease, the articular surface is devastated and associated changes result in underlying bone and soft tissues. Bone loss takes place on both the tibial and femoral surfaces of the knee joint in association with severe angular deformity. In the varus knee bone loss tends to be greater on the tibial surface and in valgus deformities the bone loss tends to be more symmetrical on the tibial and femoral surfaces. The extent of bone deficiency is usually more marked on the posterior aspect of the tibial plateau as often flexion contractures are concomitant with these marked deformities. There is associated asymmetry of soft tissues about the joint complicating the management of these deformities and most commonly soft tissue releases will be necessary on the concave side of the deformity to balance lax soft tissues on the convex side of the deformity.