A tibial cement impaction system and method are characterized by disposable frame and plunger elements which are used to drive bone cement under pressure into apertures formed in the top surface of the tibia to prevent a subsequently applied tibia plate or component of a knee prosthesis from loosening from the tibia. To prepare the tibia, the surgeon removes the top damaged surface of the tibia to define a relatively flat surface and drills a plurality of small holes or apertures into the surface. The holes are spaced across the surface. Next, the surgeon arranges the frame over the prepared tibia surface. The frame includes a wall having a generally kidney-shaped configuration which matches the outer perimeter of the top portion of the tibia and defines a chamber. Bone cement is arranged in the chamber and then the plunger, which is configured to match the contour of the wall, is pressed into the chamber, forcing the bone cement into the apertures and evenly across the top surface of the tibia. The plunger and frame are removed and discarded. Next, the tibia plate is arranged on the bone cement and driven against the tibia with the stem portion of the plate extending through the cement into the tibia. When the cement hardens, the plate is securely connected with the tibia.