73 years old gentleman with advanced osteoarthritis knee came to us with complaints of pain and swelling since 6 months. He is unable to walk or stand. On Clinical examination he had severe varus deformity left knee and restricted range of motion was noticed. Preoperative X-Ray showed arthritic of knee joint with varus deformity and large medial tibial defect. These complex deformities need meticulous surgical planning in terms of bone cuts, defects management and ligaments balancing with revision constrained knee prosthesis.

The patient underwent total knee replacement surgery with constrained prosthesis and bone defect augmentation with wedge.

Post-operative X-Ray shows well balanced knee with constrained prosthesis (LCCK) with stemmed components and medial wedge (tibial side) to augment the defect. Now patient is comfortable and walking with support.