Use of an injectable calcium phosphate bone cement in the treatment of tibial plateau fractures: a prospective study of twenty-six cases with twenty-month mean follow-up.
OBJECTIVE
To evaluate the potential benefit of a new injectable mineral bone cement (Norian SRS, Cupertino, CA, USA) for the treatment of tibial plateau fractures OTA types 41.B2-B3 and C3.


METHODS
Prospective study with established protocol.


METHODS
University hospital; university teaching hospital.


METHODS
Twenty-six patients gave informed consent to participate in this study and were available for follow-up examinations. All patients had sustained intraarticular tibial plateau fracture types OTA B2-B3 and C3. All cases were followed with a mean follow-up time of 19.7 months (6 to 36 months, median eighteen months).


METHODS
Twenty-five cases were treated with open reduction, osteosynthesis with screws or plate, and injection of Norian SRS in the subchondral bone defect. One case had closed reduction, screw osteosynthesis, and percutaneous cement injection.


METHODS
Radiographs in two planes were evaluated prospectively at six, twelve, and twenty-six weeks postoperatively and at last follow-up using Rasmussen's radiologic score. Clinical parameters were measured at the same time intervals using Lysholm's and Tegner's knee scores.


RESULTS
Two cases required early wound revisions because of sterile drainage. Two cases developed partial loss of reduction of the fracture between four and eight weeks after surgery, requiring revision surgery in one case (total complication rate 15.3 percent). No other patients had complications, and all other fractures healed without any displacement. The high mechanical strength of the cement allowed early weight bearing after a mean postoperative period of 4.5 weeks (1 to 6 weeks).


CONCLUSIONS
An injectable mineral bone cement with high initial mechanical strength was used to fill bone defects in unstable tibial plateau fractures with good success. This material offers new perspectives in the treatment of tibial plateau fractures.
Lobenhoffer
P
P
Department for Trauma and Reconstructive Surgery, Henriettenstiftung Hannover, Germany.
Gerich
T
T
Witte
F
F
Tscherne
H
H
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000008:administration & dosage; D001696:Biomechanical Phenomena; D001843:Bone Cements; D002130:Calcium Phosphates / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013978:Tibial Fractures / Q000534:rehabilitation / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing
D001672:Biocompatible Materials; D001843:Bone Cements; D002130:Calcium Phosphates; C485828:alpha-tricalcium phosphate; C485830:tetracalcium phosphate; C485838:calcium phosphate, monobasic, anhydrous; C020243:calcium phosphate; C485829:calcium phosphate, dibasic, anhydrous