International orthopaedics · 2026
Mid-term outcomes of stemless local bone autografting for moderate defects in primary total knee arthroplasty: a series of one hundred and twenty five cases.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Jalal Youssef, Zaimi Soukaina, Chouikh Younss, Bousbaa Hicham, Zejjari Hassane, Cherrad Taoufiq
Аннотация
PURPOSE: Managing peripheral bone loss during primary total knee arthroplasty (TKA) represents a technical and economic challenge in resource-constrained facilities. This study evaluates mid- to long-term outcomes of local structural bone autografting secured with cortical screws, without supplementary extension stems.
METHODS: We retrospectively reviewed 125 consecutive patients (92 females, 33 males; mean age 66.8 ± 6.2 years) treated between 2012 and 2021 for AORI Type 1 (n = 27) or Type 2A (n = 98) peripheral defects at the proximal tibia (n = 96) or distal femur (n = 29). Autologous bone cuts were manually sculpted, wedged into the defect, and fixed with two 3.5-mm cortical screws. Full weight-bearing was restricted for six weeks. Knee Society Scores (KSS), range of motion, and radiographs were analyzed. Survivorship was calculated using the Kaplan-Meier method.
RESULTS: At a mean follow-up of 7.4 ± 1.6 years (minimum, 5.0 years), mean objective KSS improved from 41.6 ± 5.8 preoperatively to 88.7 ± 5.1 at final evaluation (p < 0.001); mean functional KSS increased from 39.1 ± 6.9 to 85.4 ± 5.3 (p < 0.001). Complete radiographic graft integration occurred in 121 knees (96.8%) within 12 months. Four patients (3.2%) showed stable, asymptomatic fibrous non-union. Mechanical complications requiring revision occurred in three cases (2.4%): two late aseptic loosenings and one early resorption. Overall Kaplan-Meier implant survivorship was 97.6%.
CONCLUSION: Stemless local bone autografting with cortical screw fixation provides predictable remodeling and durable mid-term survivorship. It represents a reliable, practical alternative for managing moderate peripheral defects during primary TKA, particularly in resource-constrained settings.
METHODS: We retrospectively reviewed 125 consecutive patients (92 females, 33 males; mean age 66.8 ± 6.2 years) treated between 2012 and 2021 for AORI Type 1 (n = 27) or Type 2A (n = 98) peripheral defects at the proximal tibia (n = 96) or distal femur (n = 29). Autologous bone cuts were manually sculpted, wedged into the defect, and fixed with two 3.5-mm cortical screws. Full weight-bearing was restricted for six weeks. Knee Society Scores (KSS), range of motion, and radiographs were analyzed. Survivorship was calculated using the Kaplan-Meier method.
RESULTS: At a mean follow-up of 7.4 ± 1.6 years (minimum, 5.0 years), mean objective KSS improved from 41.6 ± 5.8 preoperatively to 88.7 ± 5.1 at final evaluation (p < 0.001); mean functional KSS increased from 39.1 ± 6.9 to 85.4 ± 5.3 (p < 0.001). Complete radiographic graft integration occurred in 121 knees (96.8%) within 12 months. Four patients (3.2%) showed stable, asymptomatic fibrous non-union. Mechanical complications requiring revision occurred in three cases (2.4%): two late aseptic loosenings and one early resorption. Overall Kaplan-Meier implant survivorship was 97.6%.
CONCLUSION: Stemless local bone autografting with cortical screw fixation provides predictable remodeling and durable mid-term survivorship. It represents a reliable, practical alternative for managing moderate peripheral defects during primary TKA, particularly in resource-constrained settings.