title: Grafting of tibial bone defects in knee replacement using Norian skeletal repair system.
abstract: BACKGROUND
  The authors have been using Norian skeletal repair system (SRS) to repair cancellous bone defects in knee replacements since 1999. Norian SRS is injectable, biocompatible calcium phosphate cement with a high mechanical strength. This product is similar to the mineral phase of bone and should undergo gradual remodeling with time. We present our experience with this bone substitute in a total of 13 knee replacement surgeries.
  
  
  METHODS
  This included three unicompartmental knee replacements (UKR), two bilateral UKR following tibial plateau fractures, five revisions of UKR to total knee replacements (TKR), two TKR revisions and one hinged knee prosthesis for significant deformity. Full weight bearing was permitted as soon as tolerated in all patients. Patients were evaluated at the latest follow-up using both the Knee Society Score (KSS) and GIUM (Italian UKR Users Group) knee scores.
  
  
  RESULTS
  At the latest follow-up, no poor results were seen with an improvement between pre-operative and post-operative knee scores in all cases. There was no evidence of bone loss or post-operative deformity. Complete compound resorption was seen in the first 4 cases.
  
  
  CONCLUSIONS
  The authors state that Norian SRS is a practical alternative as bone grafting in knee replacement surgery for type 1 and 2 bone defects.
authors.affiliation: Ist Orthopaedic Department, Centro Traumatologico ed Ortopedico (C.T.O.)-I.C.P., Via Bignami 1, Milan, Italy. alf.manzotti@libero.it
authors.forename: A
authors.initials: A
authors.lastname: Manzotti
authors.forename: N
authors.initials: N
authors.lastname: Confalonieri
authors.forename: C
authors.initials: C
authors.lastname: Pullen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001843:Bone Cements / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome; D016474:Weight-Bearing
chemical_list: D001843:Bone Cements; D002130:Calcium Phosphates; C020243:calcium phosphate