Bovine cancellous xenograft in the treatment of tibial plateau fractures in elderly patients

Abstract

The objective was to evaluate the efficacy of xenografts to improve the outcomes in elderly patients with tibial plateau fractures. Nineteen cases with a mean age of 74 years were followed prospectively from 1998 to 2003. Six patients each belonged to Schatzker types III, IV and V and one patient belonged to type II. Open reduction with fixation and xenograft impaction was carried out. Clinical and radiological union was assessed including infection rate, incorporation of the xenograft and average collapse of the fracture. The average union time was 20 weeks. No patient had wound infection and all had excellent incorporation of the xenograft with union. The average collapse was 4 mm on follow-up. This series shows the use of only an xenograft in acute fixation of these fractures with favourable outcome. Furthermore, it reduces operative time, bleeding and associated co-morbidities, which is of more significance in an elderly age group.

Proximal tibial fractures: early experience using polyaxial locking-plate technology

“…We used primary bone grafting in 45% of patients. In other series, this percentage ranges between 57% and 100% [21,22]. The mean Knee Society Score and functional score in this study were 91 and 89 points, respectively.…”

Bone regenerative medicine: classic options, novel strategies, and future directions

“…In most of them, autologous bone grafts have been suggested as the gold standard, and other methods are compared with them [4,54], yielding variable levels of effectiveness when compared to autogenous bone grafts.…”

Tibial plateau fractures: functional outcome and incidence of osteoarthritis in 125 cases

“…Surgical procedures including circular frames [1,2,18], percutaneous screw fixation [17], open reduction/internal fixation (ORIF) [1,5,6,10,28] and arthroplasty have also been advocated. More recent techniques such as the use of fixed angle devices [12,20], arthroscopically-assisted reduction [8], calcium based cement augmentation [26,29] and the use of novel grafting methods to address articular depression [4], constantly gain popularity amongst orthopaedic surgeons. Protection from weight bearing and length of immobilisation receive varied emphasis among authors [2,11,27].…”