Optimal graft choices for tibial plateau fractures with joint depression

Umut Oktem; Ozgur Selim Uysal; Muhammed Cihan Dastan; Mustafa Bulut; Ibrahim Bozkurt; Izzet Bingol; Durmus Ali Ocguder

doi:10.52312/jdrs.2025.2077

Umut Oktem¹, Ozgur Selim Uysal², Muhammed Cihan Dastan¹, Mustafa Bulut³, Ibrahim Bozkurt¹, Izzet Bingol⁴, Durmus Ali Ocguder⁴

¹Department of Orthopedics and Traumatology, Ankara Bilkent City Hospital, Ankara, Türkiye
²Department of Orthopedics and Traumatology, Private 100^th Year Hospital, Ankara, Türkiye
³Department of Orthopedics and Traumatology, Aksaray University Training and Research Hospital, Aksaray, Türkiye
⁴Department of Orthopedics and Traumatology, Ankara Yıldırım Beyazıt University, Ankara, Türkiye

Keywords: Autograft, beta-tricalcium phosphate, body mass index, tibial plateau fractures, smoking.

Abstract

Objectives: This study aims to provide insight into the advantages and disadvantages of autograft and synthetic graft use in the surgical treatment of tibial plateau fractures with joint depression by comparing the clinical and radiological outcomes of both graft types.

Patients and methods: Between February 2019 and September 2022, a total of 51 patients (23 males, 28 females; mean age: 45.3±13.5 years; range, 20 to 69 years) who underwent surgical treatment for Schatzker type 2 and type 3 tibial plateau fractures in our clinic were retrospectively analyzed. The patients were divided into two groups; 30 patients received autografts and 21 received tricalcium phosphate synthetic grafts. Demographic data, graft type, fracture classification, preoperative joint depression, body mass index (BMI), and smoking status were recorded. Postoperative evaluations included Lysholm and Visual Analog Scale (VAS) scores at two years.

Results: Similar clinical and radiological outcomes were observed in both graft groups in the short term (p>0.05). Smoking had a negative effect on graft stability, with a significantly higher postoperative depression rate in smokers (p=0.026). Patients with a BMI above 30 kg/m² also showed higher rates of postoperative depression (p=0.004). Clinical outcomes were worse in patients with joint depression compared to those without depression (p=0.003).

Conclusion: Autografts and synthetic grafts show similar efficacy in the mid-term treatment of tibial plateau fractures. High BMI and smoking may be associated with potential joint depression and worse clinical outcomes in the postoperative period.

Citation: Oktem U, Uysal OS, Dastan MC, Bulut M, Bozkurt I, Bingol I, et al. Optimal graft choices for tibial plateau fractures with joint depression. Jt Dis Relat Surg 2025;36(2):259-265. doi: 10.52312/ jdrs.2025.2077.

Author Contributions

Conception and design, collection and assembly of data, analysis and interpretation of the data: U.O., M.C.D.; Drafting of the article, critical revision of the article for important intellectual content: U.O., O.S.U, M.C.D, M.B, İ.B, İ.B, A.O. All authors read and approved the final manuscript.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.