The mid-term results of screws plus cement repair during primary total knee arthroplasty for Rand type II bone defects

【 Objective 】 To investigate the midterm results of the screws plus cement repair technique for medial tibial plateau bone defects during total knee arthroplasty. 【 Methods 】 From September 2014 to September 2019, 38 patients with Rand type II bone defects who underwent the screws plus cement technique during primary TKA were included in the study. The clinical results were evaluated via the knee society knee score (KSKS) and the knee society function score (KSFS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and range of motion (ROM). The hip–knee–ankle angle (HKAA), femorotibial angle (FTA), and radiolucent lines were assessed radiologically. 【 Results 】Onepatient had incomplete data, 1 patient died due to a traffic accident, and 1 patient was lost to follow-up. Thirty-five patients were followed up for an average of 92.6 months (60–120 months). At the last follow-up visit, the KSKS, KSFS, WOMAC score, and ROM significantly improved. The HKAA and FTA were corrected postoperatively. In 3 patients, a nonprogressive radiolucent line measuring approximately 1 mm was observed at the interface between the host bone and the cement at 3, 6 and 12 months after surgery, with an incidence of 8.3%, and no radiolucent lines were found around the screws in any of the patients at the last follow-up visit. No infection, fracture or prosthesis loosening occurred in any of the patients. 【 Conclusion 】The screws plus cement technique in primary total knee arthroplasty for the repair of Rand type II bone defects achieved satisfactory clinical and radiological results and solid fixation after a minimum 5-year follow-up period. The screws plus cement technique could be considered an economical and practical method to repair mild and moderate bone defects in primary TKA patients.