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Clinical assessment of calcium phosphate cement to treat tibial plateau fractures

The aim of this study was to examine histological changes in bone morphology after surgical treatment of tibial plateau fractures using calcium phosphate cement as a substitute for autologous bone grafting. A total of 42 patients with tibial plateau fractures were treated with open reduction, internal fixation, and calcium phosphate cement. A further 34 control patients underwent open reduction and internal fixation. Bone samples for histology were obtained during the surgery. Bone healing and functional recovery were assessed. Bone cell counts were significantly higher in samples obtained during the second surgery (81.2) compared with the first surgery (45.4, p < 0.001). Bone healing scores significantly increased with time after surgery (p < 0.001). Mean Hospital for Special Surgery knee scores were rated “good” for both the calcium phosphate cement group (82.3) and control group (79.4) in 12 months, and were not significantly different between groups. Histological examination of samples obtained during the second surgery revealed well-arranged trabeculae, in addition to new bone and blood vessel formation. These histological, radiological, and functional findings suggest that calcium phosphate cement may be an effective substitute for autologous bone grafting to treat tibial plateau fractures.