Oktem Umut, Uysal Ozgur Selim, Dastan Muhammed Cihan, Bulut Mustafa, Bozkurt Ibrahim, Bingol Izzet, Ocguder Durmus Ali
Ankara Bilkent Şehir Hastanesi, Ortopedi ve Travmatoloji Kliniği, 06800 Çankaya, Ankara, Türkiye.
Jt Dis Relat Surg. 2025 Apr 5;36(2):259-265. doi: 10.52312/jdrs.2025.2077.
This study aims to provide insight into the advantages and disadvantages of autograft and synthetic graft use in the surgical treatment of tibial plateau fractures with joint depression by comparing the clinical and radiological outcomes of both graft types.
Between February 2019 and September 2022, a total of 51 patients (23 males, 28 females; mean age: 45.3±13.5 years; range, 20 to 69 years) who underwent surgical treatment for Schatzker type 2 and type 3 tibial plateau fractures in our clinic were retrospectively analyzed. The patients were divided into two groups; 30 patients received autografts and 21 received tricalcium phosphate synthetic grafts. Demographic data, graft type, fracture classification, preoperative joint depression, body mass index (BMI), and smoking status were recorded. Postoperative evaluations included Lysholm and Visual Analog Scale (VAS) scores at two years.
Similar clinical and radiological outcomes were observed in both graft groups in the short term (p>0.05). Smoking had a negative effect on graft stability, with a significantly higher postoperative depression rate in smokers (p=0.026). Patients with a BMI above 30 kg/m also showed higher rates of postoperative depression (p=0.004). Clinical outcomes were worse in patients with joint depression compared to those without depression (p=0.003).
Autografts and synthetic grafts show similar efficacy in the mid-term treatment of tibial plateau fractures. High BMI and smoking may be associated with potential joint depression and worse clinical outcomes in the postoperative period.
本研究旨在通过比较两种移植类型的临床和影像学结果，深入了解自体移植和合成移植在手术治疗伴有关节凹陷的胫骨平台骨折中的优缺点。
回顾性分析2019年2月至2022年9月期间在我院接受手术治疗的51例Schatzker 2型和3型胫骨平台骨折患者（男23例，女28例；平均年龄：45.3±13.5岁；范围20至69岁）。将患者分为两组；30例患者接受自体移植，21例接受磷酸三钙合成移植。记录人口统计学数据、移植类型、骨折分类、术前关节凹陷、体重指数（BMI）和吸烟状况。术后评估包括两年时的Lysholm和视觉模拟量表（VAS）评分。
短期内，两组移植患者的临床和影像学结果相似（p>0.05）。吸烟对移植稳定性有负面影响，吸烟者术后凹陷率显著更高（p=0.026）。BMI高于30 kg/m²的患者术后凹陷率也更高（p=0.004）。与无关节凹陷的患者相比，有关节凹陷的患者临床结果更差（p=0.003）。
自体移植和合成移植在胫骨平台骨折的中期治疗中显示出相似的疗效。高BMI和吸烟可能与术后潜在的关节凹陷和更差的临床结果相关。
