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Volume 2, Issue 3, Pages 111-115 (September 2016) Medial tibial “spackling” to lessen chronic medial tibial soft tissue irritation J. Ryan Martin, MD, Tyler Steven Watters, MD, Daniel L. Levy, BS, Jason M. Jennings, MD, DPT, James P. Boyle, PA-C, Douglas A. Dennis, MD Arthroplasty Today Volume 2, Issue 3, Pages 111-115 (September 2016) DOI: 10.1016/j.artd.2016.05.003 Copyright © 2016 The Authors Terms and Conditions

Figure 1 Intraoperative photo demonstrating medial tibial bone loss with resultant prominence of the cobalt–chrome revision tray. Arthroplasty Today 2016 2, 111-115DOI: (10.1016/j.artd.2016.05.003) Copyright © 2016 The Authors Terms and Conditions

Figure 2 Intraoperative photo demonstrating drilling of the proximal tibia for cement pressurization. Arthroplasty Today 2016 2, 111-115DOI: (10.1016/j.artd.2016.05.003) Copyright © 2016 The Authors Terms and Conditions

Figure 3 Intraoperative photo demonstrating the prepared bone before cement spackling. Arthroplasty Today 2016 2, 111-115DOI: (10.1016/j.artd.2016.05.003) Copyright © 2016 The Authors Terms and Conditions

Figure 4 Intraoperative photo demonstrating cement spackling with a freer. Arthroplasty Today 2016 2, 111-115DOI: (10.1016/j.artd.2016.05.003) Copyright © 2016 The Authors Terms and Conditions

Figure 5 Intraoperative photo showing cured cement shaped to normal contour of the proximal medial tibia. Arthroplasty Today 2016 2, 111-115DOI: (10.1016/j.artd.2016.05.003) Copyright © 2016 The Authors Terms and Conditions

Figure 6 Additional intraoperative photo showing cured cement after spackling which fills the void from the medial tibial bony resorption with no subsequent prominence of the revision tibial tray. Arthroplasty Today 2016 2, 111-115DOI: (10.1016/j.artd.2016.05.003) Copyright © 2016 The Authors Terms and Conditions

Figure 7 Anteroposterior (AP) radiograph of the left knee before revision TKA on initial presentation. Arthroplasty Today 2016 2, 111-115DOI: (10.1016/j.artd.2016.05.003) Copyright © 2016 The Authors Terms and Conditions

Figure 8 Six-week postoperative AP radiograph of the left knee after revision TKA. Arthroplasty Today 2016 2, 111-115DOI: (10.1016/j.artd.2016.05.003) Copyright © 2016 The Authors Terms and Conditions

Figure 9 One-year postoperative AP radiograph of the left knee demonstrating medial tibial bone loss. Arthroplasty Today 2016 2, 111-115DOI: (10.1016/j.artd.2016.05.003) Copyright © 2016 The Authors Terms and Conditions

Figure 10 Two-year postoperative AP radiograph of the left knee demonstrating progressive medial tibial bone loss. Arthroplasty Today 2016 2, 111-115DOI: (10.1016/j.artd.2016.05.003) Copyright © 2016 The Authors Terms and Conditions

Figure 11 Recent follow-up AP radiograph of the left knee 2.5 years after medial tibial “spackling.” Arthroplasty Today 2016 2, 111-115DOI: (10.1016/j.artd.2016.05.003) Copyright © 2016 The Authors Terms and Conditions