In case of the large bone defect due to severe varus or valgus deformity in total knee replacement, there are many different methods for reconstruction of the bone defect for insertion of the tibial component after resection of the proximal tibia. Total knee replacement using the autogenous bone graft were performed in 27 knees (18 patients) with tibial bone defect. Authors report the methods and results with an average 23 months follow-up. We used the bone removed from distal femur and calculated the size of the proximal tibia. We used the screws, if necessary, for rigid fixation of the grafted bone. l. According to the type of bone defect, central defect type were 3 knees, peripheral defect type were 13 knees and combined type were 11 knees. 2. In A-P view of x-ray, the size of bone defect of the tibial plateau ranged 5mm to 25mm (average 11.1mm) in height. 3. Screws were used for fixation of grafted bone in 14 knees and the average size of the screws was 27.8mm. 4. Bony union of the grafted bone achieved from 3 months to 12 months (average 5.7months). 5. Average knee ROM was 105 degrees and improved post-operatively 121 degrees, and average flexion contracture was 22.4 degrees and improved post-operatively 7.5 degrees. 6. Post-operative tibiofemoral angle was average 7.5 degrees valgus. 7. Average knee rating score was 54.5 and improved post-operatively 89.2 8. The comlication of bone graft was partial resorption in 1 case and the loosening or displacement due to screw were abscent.