Tibial Wedge Augmentation for Bone Deficiency in Total Knee Arthroplasty

This report constitutes a followup of a previous study of 28 knees in 25 patients with metal wedge augmentation for tibial bone deficiency. Those patients were reviewed 2.3 years after surgery; 79% had excellent results, and 21% had good results. Twenty-four knees in 21 patients with a metal wedge augmentation for tibial bone deficiency were reviewed 5.6 years clinically and 4.8 years radiographically after surgery. Clinical results were excellent in 67%, good in 29%, and poor in 4%. The only poor result was in 1 knee that required 2 revision procedures: the first for failure of a metal-backed patellar component and the second for aseptic loosening of the femoral component. Radiolu-cent lines at the cement bone interface beneath the metal wedge were present in 13 knees. Eleven of those radiolucencies were <1 mm in width, and 2 were 1 to 3 mm in width. None of those lucent lines were progressive. Metal wedge augmentation for tibial bone deficiency is a useful option. No deterioration of the wedge-prosthesis or wedge-cement-bone interface was seen at midterm followup.