Does autologous bone grafting provide better outcomes than tricalcium phosphate synthetic grafting in tibial plateau fractures with articular depression? Eklem yüzeyinde çökmesi olan tibia plato kırıklarında otolog kemik greftlemesi, trikalsiyum fosfat sentetik greften daha üstün mü?
Ulusal Travma ve Acil Cerrahi Dergisi, cilt.32, sa.5, ss.602-609, 2026 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 5
- Basım Tarihi: 2026
- Doi Numarası: 10.14744/tjtes.2026.23622
- Dergi Adı: Ulusal Travma ve Acil Cerrahi Dergisi
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, TR DİZİN (ULAKBİM), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.602-609
- Anahtar Kelimeler: Autograft, functional outcome, reduction loss, tibial plateau fracture, tricalcium phosphate synthetic graft
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
BACKGROUND: This 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. METHODS: In 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. RESULTS: Both 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). Donor-site morbidity occurred in 4.7% of patients in the autograft group, whereas no graft-related complications were observed in the TCP group. CONCLUSION: In 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 mid-term 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.