ArticleUlusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES2026
Does autologous bone grafting provide better outcomes than tricalcium phosphate synthetic grafting in tibial plateau fractures with articular depression?
Article in Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aimed to compare the radiological and functional outcomes of autologous iliac bone grafting and tricalcium phosphate synthetic grafting in the treatment of tibial plateau fractures (TPFs) with articular depression.
methodsIn this retrospective comparative study, 94 patients who underwent surgical treatment for Schatzker type II-III tibial plateau fractures with metaphyseal depression between January 2015 and June 2022 were evaluated. Patients were divided into two groups according to the graft material used: autologous iliac bone graft (n=42) and tricalcium phosphate (TCP) synthetic graft (n=52). Radiological evaluation included measurement of articular depression (mm) and the modified Rasmussen Radiological Score (RRS) preoperatively, postoperatively, and at final follow-up (≥36 months). Functional outcomes were assessed using the Lysholm Knee Score and the modified Rasmussen Functional Score (RFS). The minimum follow-up duration was 36 months.
resultsBoth groups achieved satisfactory initial correction of articular depression. At final follow-up, depression was smaller in the autograft group (2.10 [0.00-2.60] mm) than in the TCP group (2.50 [1.68-3.75] mm; U=771.5, p=0.014), indicating better maintenance of reduction. RRS values were comparable between groups preoperatively and immediately postoperatively, but were higher in the autograft group at final follow-up (16 [16-18] vs. 16 [14-16]; U=1453.5, p=0.002). Consistent with this finding, a greater proportion of excellent RRS outcomes was observed in the autograft group (40.5% vs. 21.2%; χ²(1)=4.15, p=0.042). Functional outcomes were similar between groups (RFS: 27 [26-28] vs. 26 [26-28]; U=1285, p=0.136; Lysholm: 86 [81-90] vs. 86 [81-90]; U=1271.5, p=0.159). Donorsite morbidity occurred in 4.7% of patients in the autograft group, whereas no graftrelated complications were observed in the TCP group.
conclusionIn Schatzker type II-III TPFs with articular depression, autologous iliac crest bone grafting demonstrated better radiological maintenance of reduction and higher final RRS compared to TCP grafting, although midterm functional scores were similar. These level III data suggest that autograft remains a reliable option for structural support in metaphyseal defects; however, prospective randomized comparative studies are needed to confirm any potential advantage over tricalcium phosphate grafts.
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