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The Journal of Bone and Joint Surgery, Vol 66, Issue 3 328-335, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
Late osteochondral allograft resurfacing for tibial plateau fractures
RC Locht, AE Gross and F Langer
Seventeen patients in whom secondary degenerative arthritis developed after
a tibial plateau fracture underwent osteochondral allograft resurfacing of
the involved plateau. The transplantation was done within twenty-four hours
of procurement of the allograft from a cadaver donor so that viable
cartilage would be used. There were sixteen tibial resurfacing grafts, and
one patient had a tibial and femoral graft. Twelve patients have been
followed for more than two years. A rating system for pain and function
showed marked improvement in ten of the twelve patients. The clinical
results were not related to age, interval from injury to grafting, type of
graft, length of follow-up, or radiographic data. We believe that
appropriate selection of patients for the procedure was the factor that led
to the best results. Collapse of the osseous portion of the graft measuring
more than three millimeters occurred in two patients, and there was
obliteration of the cartilaginous joint space in one patient. This method
of joint resurfacing requires minimum resection of tissue and avoids the
use of a prosthesis. The ultimate fate of these grafts is not known, but
the results in our series were encouraging. however, at this time the
procedure should be restricted to younger patients with disabling,
localized post-traumatic arthritis.
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