Fresh frozen allograft bone was used to fill defects during revision total knee replacements in 21 patients (21 knees) using radial impaction grafting technique. Radial Impaction grafting technique produces a very rigid bone cement construct to allow for immediate weight bearing without any reinforcements. The strength of the graft substitute with stems allowed us to avoid metal augments in both type II and type III defects in majority of cases. At a minimum of 12 months follow up (12 to 60 months follow up, average 28 months), 19 of the knees showed radiological incorporation of the graft and no evidence of lysis of bone graft. Radiological incorporation of the graft was seen as early as six months and remodelling was continuing at three years. There were no cases of non-union. There were no cases of collapse of the graft or migration of the implant. There was one cases of osteolysis due to deep infection, which needed re-operation. There was one case of traumatic peri-prosthetic fracture, which was treated conservatively.

Oxford knee scores improved from an average of 45 (35 to 53) to 17.4 (12 to 22) at an average follow up of 27.4 months. American Knee Society scores improved from an average of 39.8 (31 to 53) to 87.8 (30 to 70). Knee Society Function scores improved from an average of 45 (30 to 70) to 85 (65 to 100) at last follow-up.

We recommend use of radial impaction grafting technique to fill defects of type II and type III in Tibias during revision knee arthroplasty.