Porous titanium granules are better than autograft bone as a bone void filler in lateral tibial plateau fractures

Abstract

A total of 20 patients with a depressed fracture of the lateral tibial plateau (Schatzker II or III) who would undergo open reduction and internal fixation were randomised to have the metaphyseal void in the bone filled with either porous titanium granules or autograft bone. Radiographs were undertaken within one week, after six weeks, three months, six months, and after 12 months. The primary outcome measure was recurrent depression of the joint surface: a secondary outcome was the duration of surgery. The risk of recurrent depression of the joint surface was lower (p < 0.001) and the operating time less (p < 0.002) when titanium granules were used. The indication is that it is therefore beneficial to use porous titanium granules than autograft bone to fill the void created by reducing a depressed fracture of the lateral tibial plateau. There is no donor site morbidity, the operating time is shorter and the risk of recurrent depression of the articular surface is less.

Surgical Technique of Anterolateral Approach for Tibial Plateau Fracture

“…A raft–screw plate is chosen. The articular surface is supported not only by a bone allograft but also by the raft screws.…”

Use of Osteobiologics for Fracture Management: The When, What, and How

“…Titanium can perform as a bioactive material by modification of the surface characteristics obtaining micro-sized roughness. Jónsson randomized patients to titanium granules vs. autogenous graft and found superiority of titanium granules [112] . In addition to mechanical refinement, chemical surface treatment can also be utilized to inflect angiogenesis and trigger osteoblasts thereby accelerating healing.…”

Articular impaction injuries in the lower limb

“…The final outcome is closely correlated with the accuracy of the underlying reduction achieved (Table 1). 18,33-43 …”

“…56 Several studies have shown no significant difference in the clinical outcomes between cases treated with autografts or allografts and bone graft substitutes. 39,40,42,43 It should be mentioned that any concomitant injuries, such as meniscal tears or ligament ruptures, should be addressed simultaneously as they can negatively compromise the final outcome. Satisfactory results do not always correlate with the radiological appearance, possibly due to the function of the menisci that can bear weight and relieve pressure over the lateral compartment…”