An Overview about Management of Tibial Bone Defects in Varus Deformity

Abstract

A variety of management alternatives exists for bone deficiencies encountered at the time of TKA. The alternatives for management include increased bone resection, translation of the component away from the deficiency, filling the defect with cement with or without reinforcing screws or mesh, bone grafting, and metal augmentation. Bone resection is quick and easy option but it should be reserved for shallow defects because deep proximal tibial resection places the tibial component on relatively weak cancellous bone, danger of compromise of important ligament attachments,  both gaps are increased, requiring a thicker tibial component for stability which will alter the patellofemoral kinematics and finally Sizing problems will likewise occur because of the diminished cross-sectional area as one progresses down the tibia distally . For defects larger than 10 mm depth, alternative methods of fixation probably should be used.