Arthroscopic restoration of depressed tibial plateau fractures using bone and hydroxyapatite grafts.

Depressed tibial plateau fractures in 13 patients were treated under arthroscopic control. In 3 patients, bone autograft was used; in the remaining 10, hydroxyapatite (HAP) grafts were used. The depression of the articular surface was managed by elevation of the subchondral plate through a small window. Assisted by fluoroscopy, we corrected and performed the grafting under arthroscopic control. Follow-up periods averaged 5 years 6 months for the autograft and 18 months for the HAP grafts. At the conclusion of the follow-up period, x-ray radiographs and computed tomography (CT) scan showed no evidence of arthrosis and knee motion was normal. There were no significant differences between the two groups. The interporous spaces showed new bone formation on closed biopsy 6 months postoperatively.