Fixation augmentation using titanium cage packing with xenograft in the treatment of tibial plateau fractures.

OBJECTIVES

To evaluate a new surgical technique concerning titanium cage packing with xenograft demineralized bone matrix bovine augmentation in the management of subchondral bone defects associated with tibial plateau fractures.

METHODS

All patients underwent plate fixation augmentation using titanium cage packing with xenograft, with the help of digital medical software of Mimics and 3-matic preoperatively. Duration of the surgical procedure, intraoperative bleeding volume, bone union time, quality of reduction and alignment, fracture healing, complications, and functional outcomes based on Oxford knee outcome score were recorded.

RESULTS

A total of 18 patients were followed for average 18.1 months (range, 12-24 months). The average radiographic bony union time was 12.8 weeks (range, 11-17 weeks) and full weight bearing time was 13.4 weeks (range, 11-16 weeks) respectively. At one-year follow-up, the mean degrees of knee extension were 2.7° (range, 0-6) and the mean degrees of knee flexion were 122.0° (range, 112-134). The articular step-off was unchanged from 0.9 ± 0.6 mm (range, 0-1.8 mm) to 1.0 ± 0.6 mm (0-1.9 mm) (P = 0.512). All the cases had satisfactory reduction. No secondary loss of reduction was found over the time period studied. Superficial infection was found in one case, and resolved with closed treatment. No implant failures were noted. The average Oxford knee score was 19.9 ± 5.4 (range, 12-30) at the final follow-up.

CONCLUSION

Fixation augmentation using titanium cage packing with xenograft augmentation is a safe and effective way to treat the depressed tibial plateau fractures.