J Korean Fract Soc.  2010 Jan;23(1):26-33. 10.12671/jkfs.2010.23.1.26.

The Use of Fresh Frozen Allogenic Bone Graft in the Impacted Tibial Plateau Fractures

• Kim YJ
• Chae SU
• Yang JH
• Lee JW
• Wi DH
• Choi DH

• KMID: 1461569
• DOI: http://doi.org/10.12671/jkfs.2010.23.1.26

Abstract

PURPOSE
To assess the behaviour of fresh frozen cancellous allograft used for supporting the reconstructed articular surface in impacted tibial plateau fractures.
MATERIALS AND METHODS
Between May 2004 and May 2008, 13 cases of impacted tibial plateau fracture were evaluated retrospectively. All fractures were treated with open reduction-internal fixation after restoration of the tibial plateau surface and insertion of fresh frozen cancellous allograft chips for subchondral support. Mean age was 46.6 (31~65) years. Average follow-up period was 36 (13~58) months. The radiological and clinical result for every patient was assessed according to the modified Rasmussen's system and Lysholm's knee score.
RESULTS
According to last follow-up weight bearing A-P X-ray, the fresh frozen cancellous allograft incorporated soundly in all cases and no complications such as joint depression, fracture reduction loss, angular deformity, and malunion were found. The mean time to complete bone union was postoperative 10+/-0.7 weeks. The mean range of motion was 135 (115~145) degrees. The mean Rasmussen's radiological score at last follow up was 15.3 (10 cases: excellent, 3 cases: good). The mean Lysholm's knee score at last follow up was 88.2+/-4.3.
CONCLUSION
We concluded that fresh frozen cancellous allograft in impacted tibial plateau fractures showed good results in terms of bone union and functional improvement and was considered to be a good structural supporter.

Keyword

Knee; Tibial plateau fracture; Allogenic bone graft

MeSH Terms

Congenital Abnormalities
Depression
Follow-Up Studies
Humans
Joints
Knee
Range of Motion, Articular
Retrospective Studies
Transplantation, Homologous
Transplants
Weight-Bearing

Figure

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  Fig. 1 Preoperative anteroposterior and lateral radiograph of 65-year old male patient with Schatzker type II depressed lateral tibial plateau fracture (arrow).

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  Fig. 2 Preoperative MRI (arrow) showed the more depression of lateral tibial plateau.

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  Fig. 3 Postoperative radiograph showed the fixed T-plate after open reduction and cancellous impacted allogenous bone graft.

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  Fig. 4 The last follow-up radiograph showed the complete bone union and no depression of tibial plateau.

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  Fig. 5 Preoperative anteroposterior radiograph (A) and MRI image (B) of 47-year old female patient with Schatzker type IV depressed medial tibial plateau fracture (arrow).

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  Fig. 6 (A) The postoperative radiograph showed the 2 K-wires after open reduction and cancellous impacted allogenous bone graft, posterior cruciate ligament reconstruction and repair of posterolateral capsule. (B) The last follow-up radiograph showed the complete bone union and no depression of tibial plateau.

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  Fig. 7 Arthroscopic finding (arrow) after anatomical reduction of medial tibial plateau.

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  Fig. 8 Preoperative anteroposterior radiograph (A) and MRI image (B) of 58-year old female patient with Schatzker type II depressed lateral tibial plateau fracture (arrow).

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  Fig. 9 The postoperative (A) and last follow-up (B) radiograph showed the complete bone union and no depression of tibial plateau.

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