Osteochondral Autoplasty of the Extensive Post-Traumatic Defect of the Proximal Tibia

Application of the original method of autoplasty of the extensive osteochondral defect of the proximal part of the tibia from the posterior femoral condyle is described. A patient was operated on for the malunion of the intraarticular fracture of the lateral condyle of the tibia with the impression of osteochondral fragments. Autoplasty of the osteochondral defect of the tibia was performed from the posterior parts of the femur condyle, using fixation by tension-locked k-wires. Osteotomy zone for obtaining a transplant may vary depending on the intensity of the cartilage covering and condyle curvature. The authors tried to exert minimum damage to the weight-bearing zones of the posterior femur condyle obtaining a sufficient size of the graft and zone of its coverage by the cartilage. The remote result was evaluated in a year and 10 months after the operation and revealed neither misalignment of a clinical axis of the extremity, nor knee instability, and its full extension. The patient performed full deep squats without any additional support. On the control radiograph the knee joint surface was congruent, any signs of loosening of metal components were not observed. Remodelling of the posterior femur condyle in the form of contour smoothing in the zone of osteotomy was noted. The autoplasty technique used showed a high efficacy, and allowed to restore completely the function of the knee joint to the degree enabling participation in the sports activities.

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Malyshev E.E., Hjorleifur Skorri Thormodsson, Korolyov S.B., Pavlov D.V., Kuvshinov S.G. Osteochondral Autoplasty of the Extensive Post-Traumatic Defect of the Proximal Tibia. Sovremennye tehnologii v medicine 2014; 6(2): 142