ABSTRACT
BACKGROUND: Bone defects are one of the most important challenges that surgeons have to manage in total knee arthroplasty. The reasonable treatment method can guarantee the effect of the repair operation. OBJECTIVE: To review the relevant literatures concerning bone defects treated by primary total knee arthroplasty and revision total knee arthroplasty, and to analyze the optimal managements for different types of bone defects. METHODS: Relevant literatures were identified in China National Knowledge Infrastructure, Wanfang data, Vip, PubMed, Medline, and Web of Science. The key words were "total knee arthroplasty, total knee replacement, revision total knee arthroplasty, bone loss, bone defect, bone deficiency, management". The included studies were analyzed and summarized. RESULTS AND CONCLUSION: (1) Sixty-two studies regarding total knee arthroplasty for bone defects were included, without recognized standards on the type of bone defects. AORI is the most widely used classification for bone defects. (2) Pre-operated detailed evaluation including laboratory and radiographic examination, and accurate diagnosis are the key to success. (3) Management of bone defect was similar in tibia and femur, but there is still no standard classification and management of patellar bone defect. (4) Using stem fixation whenever a femoral or tibial component is revised can improve clinical outcome. (5) Through detailed evaluation, accurate diagnose and appropriate classification of bone defect, selection, according to the characteristics of different strategies, the age of the patient and the needs of life, can get a good clinical result.