Follow-up Study Of Bone Cement Combined With Screws For Repairing Tibial Defects In Total Knee Arthroplasty

Objective:To explore the clinical effect of repairing tibial defects with bone cement and screws in total knee arthroplasty in our hospital.Method:76 knee joints of 65 patients admitted from January 2010 to January 2017 were analyzed retrospectively.During the follow-up period,one patient died of other causes,including 64 cases and 75 knee joints.There were22 male patients(24 knees)and 42 female patients(51 knees).The mean follow-up months were 72.1 ± 19.53.Among them,26 patients had normal tibial plateau without defect;the rest had medial tibial plateau defect.According to Rand classification,16 patients had type a and 33 patients had type b.The patients with normal tibial plateau were treated with total knee arthroplasty(group A),the patients with tibial plateau defect Rand a type were treated with bone cement alone(group B),and the patients with tibial plateau defect Rand b type were treated with bone cement and screws(Group C).ROM and AKS scores of knee joint were calculated before and after operation,and the data were analyzed statistically.Result:The follow-up time of 64 cases(75 knees)was 40-106 months,with an average month of 72.1 ± 19.53.Until the last follow-up,there was no infection around the prosthesis in the knee joint of the patient.The prosthesis was stable and no loosening,and the lower limb force line was normal.4 patients had a translucent band around the prosthesis,but there was no progressive progress.The knee AKS score of group A patients increased from73.47± 6.24 before operation to 170.85 ± 5.94 after the last follow-up;the knee AKS score of group B patients increased from 74.96 ± 15.41 before operation to the last follow-up of 173.71±6.28 after operation;The knee AKS score of group C score of the joint increased from 72.68±16.29 before operation to 171.04±9.19 at the last follow-up.The difference in AKS score of the knee joint between patients before and after operation was statistically significant(P <0.05).There was no significant difference in knee AKS scores between bone cement combined with screw(group C),conventional replacement(group A)and simple bone cement filling(group B)(P> 0.05).Conclusion:1.For patients with severe knee varus deformity and tibial defect,make full preparations before surgery,Rand classification helps to formulate a reasonable surgical plan.2.Operate carefully during the operation,perform osteotomy according to individual differences,choose a suitable prosthesis,and perform functional exercise early after the operation.3.Bone cement combined with screws in the repair of tibial defect in total knee arthroplasty,the medium and long-term results are satisfactory,and its reliability is no difference compared with conventional replacement and simple bone cement filling.