• Alexander Hanke, Martin Bäumlein, Siegmund Lang, Boyko Gueorguiev, Michael Nerlich, Thomas Perren, Paavo Rillmann, Christian Ryf, Theodore Miclau, and Markus Loibl.
• Department of Orthopaedic Trauma Surgery, Spital Davos, Davos, Switzerland; Department of Trauma Surgery, Regensburg University Medical Center, Regensburg, Germany.
• Injury. 2017 Dec 1; 48 (12): 2807-2813.

ObjectivesSynthetic bone grafts (SBGs) are widely used to fill bone defects after fracture reduction. This study assessed the long-term resorption of two different calcium phosphate products (A=ChronOS™ inject and B=Norian® SRS®; both DePuy Synthes, Oberdorf, Switzerland) used in the surgical treatment of tibial plateau fractures.DesignLong-term clinical and radiologic follow-up of 52 patients after surgical treatment of intraarticular tibial plateau fractures augmented with SBGs.SettingThe study was performed at a level 3 trauma center.PatientsBetween January 2000 and December 2006 a total of 52 patients with intraarticular tibial plateau fractures were operatively treated and augmented with SBGs consisting of a Brushite matix with β-TCP granules (SBG A) or hydroxylapatite with 4-6% carbonate content (SBG B). 46 patients could be contacted and 38 were included in the study. Half of the patients received SBG A and the other half SBG B.Main Outcome MeasurementsLoss of reduction and SBG resorption was investigated by comparison of follow-up X-ray images to pre- and postoperative X-ray images. Furthermore, pain, activity level and knee function were evaluated by means of questionnaires and clinical examination.ResultsThe mean age of patients was 59.7±12.5years. The follow-up was 8.6±0.9years for SBG A and 11.6±1.4years for SBG B (p<0.001). In most cases SBG A was completely resorbed in a homogenous pattern, while SBG B was still visible on the X-ray images revealing a peripheral resorption pattern. A loss of reduction (>2mm) could be observed in two patients with SBG A and two patients with SBG B, although only one of them had an impaired knee function.ConclusionsThe composite SBG A reveals a comprehensive long-term resorption in comparison to SBG B. Nevertheless, both provided suitable mechanical support as part of the surgical treatment of tibial plateau fractures.Level Of EvidenceCase series, Level IV.Copyright © 2017 Elsevier Ltd. All rights reserved.

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