Currently, the number of primary knee joint arthroplasty (KJA) cases has increased annually and there are a substantial number of patients possessing the bone defects of the tibial plateau. How to select appropriate biomaterials for repairing the tibial plateau bone defects and acquire satisfactory results from primary KJA has gradually turned into a burning research area. Effective repair results are the basis of the initial stability of the knee joint implants, which confirms that patients can obtain satisfactory results within the life expectancy of the prosthesis. At present, there are a variety of materials used to repair tibial plateau bone defects in primary KJA. In this review, we summarized advantages and disadvantages of different materials used in repairing tibial plateau bone defects and hope to provide certain references for selection of appropriate materials during treatment. Proper biomaterials used to repair bone defects of the tibia plateau include traditional materials (structural bone grafts, bone cement, segmental metal augments, and tantalum cones) and new biomaterials (tissue-engineered bone, autologous platelet-rich plasma, and autologous chondrocytes). Such materials possess their own characteristics, advantages, and limitations. Traditional repair biomaterials generally tend to have difficulties like bone resorption, secondary breakdown, stress shielding, and implant loosening. Newly developed biomaterials have delivered new opportunities for treating these diseases during early stages. However, the clinical security and long-term effectiveness of these biomaterials must be further tested. Apposite biomaterials should be selected for repairing the bone defects as per the precise size and depth of the tibial plateau.