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Peripheral bony defects of the tibia can be seen in patients with osteoarthritis of the knee. These defects must be corrected at the time of total knee replacement to ensure correct placement and alignment of the components.    We describe a new technique for correcting large tibial defect by using bone graft, where the uncontained defects were converted to contained defects using bone graft and the contained defect was impacted with cancellous bone. Between 2006 and 2010, 48 cases of primary total knee arthroplasty were reconstructed using autologous bone graft. Of 48 cases, five cases had large tibial defect and were treated with the new technique. Collapse was seen in one knee at 5 months postoperative. The rest of the patients showed improvement in total knee score and limb alignment.    We now use this technique to treat large tibial defect during total knee replacement.

Biological Reconstruction of Varus Deformity in Primary Total Knee Replacement Using Bone Graft and Description of a New Technique