A slurry of cancellous bone is obtained from the cut undersurface of the tibial wafer (Fig. 7.6). The patellar reamers are utilized for
this purpose. This biologic bone "cement" is applied to every surface on the tibia, femur, and patella. In a routine varus knee, the bone is more porotic on the lateral side, and care is taken to spread additional bone slurry on the lateral tibial plateau to improve the contact between the implant porous coating and bone. This also serves to reinforce the bone in this region and rebuild the subchondral plate.
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