A new knee arthroplasty versus Brown procedure in congenital total absence of the tibia: a preliminary report.

The rates of successful knee arthroplasties according, for example, to Brown in patients with congenital total absence of the tibia are disappointing. A new form of knee arthroplasty is demonstrated in a 15-month-old infant with a congenital total absence of the tibia. With the help of two crossed capsular flaps and a Z-plasty of the quadriceps tendon, the patella is transposed under the femoral condyles to function as a tibial plateau. The proximal fibula is fused centrally to the external, cortical surface of the patella. A mini-ringfixator construction is used to stabilize the components, although permitting mobilization of the knee arthroplasty in the immediate postoperative period. This new type of knee arthroplasty offers distinct advantages compared with the previously published procedures.