Bone Allograft in Knee Arthroplasty with Varus Deformity

Relevance. With the growing demand for knee arthroplasty, orthopedic surgeons increasingly encounter advanced gonarthrosis cases accompanied by severe varus deformity and critical bone defects of the proximal tibia. While the use of structural allografts is well-established in revision surgery, their role and technical nuances in primary knee arthroplasty, particularly for AORI T2A-type defects, are insufficiently covered in the literature. This creates a lack of standardized solutions for situations where standard methods (bone cement, metal augments) may be suboptimal. Case description. This article presents a clinical case of a 60-year-old female patient with severe varus deformity and a critical marginal bone defect of the medial tibial condyle. To address the defect during primary total knee arthroplasty, alloplasty using a ready-made structural allograft was performed. This method avoided autogenous bone graft harvesting and its associated complications, while also creating an anatomically precise and biomechanically stable support platform. Intraoperatively, after staged soft-tissue release and deformity correction, the defect was prepared, the allograft was contoured and stably fixed with compression screws. Control assessment confirmed optimal construct stability and complete correction of the limb axis. Conclusion. This clinical case demonstrates that alloplasty using a structural allograft is an effective and reliable solution to the complex problem of extensive bone defects in primary knee arthroplasty. This approach not only provides a solid foundation for component fixation but also allows for radical correction even in cases of severe initial deformity, opening prospects for successful treatment of patients with severe gonarthrosis. Early postoperative results indicate full restoration of the limb's biomechanical axis and satisfactory implant positioning. Despite the success, further studies with long-term follow-up are needed to assess graft integration and long-term outcomes.