PLASTY OF THE PROXIMAL TIBIAL METAPHYSIS BY CREATING A SUPPORT BASE FOR THE ARTICULAR SURFACE

In the modern world literature, there are various opinions, sometimes contradictory, regarding the tactics of bone replacement of the proximal metaphysis of the tibia as a result of a tumor lesion.

The objective is to demonstrate on a clinical example the method of plasty of a defect in the proximal metaphysis of the tibia by creating a support base for the articular surface in a giant cell tumor of the tibia.

Clinical case. A 39-year-old patient underwent a surgery - marginal resection of the tibia with an original method of bone grafting with a rotated fragment of the fibula on the vascular pedicle.

Results. In the long-term postoperative period, the AOFAS score was 97 points. There are no signs of recurrence or malignancy of the tumor. The patient is satisfied with the surgical treatment performed. With traditional bone grafting, pronounced deformity of the knee joint develops, which complicates the technique of surgery and the selection of a joint implant. The proposed method of replacing an extensive defect formed after resection of the affected area of the tibia involves the creation of a support base for the articular surface, which significantly reduces the risk of deforming osteoarthritis of the knee joint (patent for invention No. 2328237).

Conclusion. Our proposed method of replacing a bone defect formed after resection of the affected area of the tibia involves the creation of a support base for the articular surface, which significantly reduces the risk of deforming osteoarthritis of the knee joint. And in cases where there is a need for knee replacement, it facilitates the technique of surgical aids and the selection of an implant.

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