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. 2023 May;143(5):2447-2454.
doi: 10.1007/s00402-022-04461-x. Epub 2022 May 10.

Radiographic and clinical outcome of tibial plateau fractures treated with bone allograft

Sarah Meiser  1 , Rohit Arora  2 , Johannes Petersen  3   4 , Alexander Keiler  2 , Michael C Liebensteiner  2 , Johannes Dominikus Pallua  2 , Alexander Wurm  5
Affiliations

Radiographic and clinical outcome of tibial plateau fractures treated with bone allograft

Sarah Meiser et al. Arch Orthop Trauma Surg. 2023 May.

Abstract

Background: To determine the clinical outcome of patients who had been treated with bone allografts during open reduction and internal fixation (ORIF) of tibial head fractures.

Methods: Patients who suffered a medial, lateral, or bicondylar fracture of the tibial plateau and underwent surgical treatment by open reduction and internal fixation (ORIF) using human femoral head bone allografts were included. Patients were invited to provide information for the following: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQol Five Dimension score (EQ-5D), Lower Extremity Functional Scale (LEFS) and Parker Mobility Score. Bone mineral density (BMD) of the allograft area and the healthy human bone tissue were measured by quantitative computed tomography.

Results: A total of 22 patients with a mean follow-up time of 2.88 ± 2.46 years were included in our study. The most common fractures observed in this study were classified as Schatzker II (11 patients, 50.0%) or AO/OTA 41.B3 (12 patients, 54.5%) fractures. Postoperative WOMAC total was 13.0 (IQR = 16.3, range 0-33). Median quality of life (EQ-5D) score was 0.887 ± 0.121 (range 0.361-1.000). Median Lower Extremity Functional Scale (LEFS) score was 57.5 ± 19.0 (range 33-79). Mean Parker Mobility Score was 9 (range 6-9). Median bone mineral density (BMD) for the whole group was 300.04 ± 226.02 mg/cm3 (range - 88.68 to 555.06 mg/cm3) for region of interest (ROI 5) (central), 214.80 ± 167.45 mg/cm3 (range - 7.16 to 597.21 mg/cm3) for ROI 1-4 (marginal zones: medial, lateral, ventral, dorsal) and 168.14 ± 65.54 mg/cm3 (range 17.47-208.97 mg/cm3) for healthy bone tissue (femur and tibia).

Conclusion: Based on WOMAC scores, LEFS, ambulatory status, and quality of life findings, it can be concluded that following tibial head ORIF with allograft bone patients has promising results.

Keywords: Bone allograft; Bone graft; Bone mineral density; Quantitative computed tomography; Tibial plateau fractures.

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Conflict of interest statement

The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the article.

Figures

Fig. 1
Fig. 1
Example illustrating the placement and determination of bone mineral density using CT images. A 3D reconstruction of the right knee; B measurement of BMD of the marginal zones (ROI 1–4, medial, lateral, ventral, dorsal) and the central BMD (ROI5); C measurement of BMD of the healthy tissue of the femur and the tibia
Fig. 2
Fig. 2
Flowchart for patient inclusion
Fig. 3
Fig. 3
Presentation of the central BMD, the marginal zones BMD (mean value of the BMD of the medial, lateral, ventral, dorsal marginal zones) and the adjacent healthy bone (mean value of the BMD of the tibia and femur) for n = 22 using a box plot representation. The median ± interquartile range in mg/cm3 and the minimum and maximum measured values are shown
See this image and copyright information in PMC

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