|Beitragstitel||Fresh Osteoarticular Allograft Reconstruction in Posttraumatic Articular Defect of the Lateral Tibial Plateau|
Posttraumatic osteoarticular defects around the knee remain a challenging issue in orthopaedic surgery. Joint preservation should be considered whenever possible, especially in young patients. Osteoarticular Allograft Transplantation (OAT) is described mainly after tumor resection with promising outcome, but only a few publications describe OAT in posttraumatic reconstruction.
A 34-year-old man sustained a lateral tibial plateau fracture of the right knee during skiing (Fig. 1). Open reduction and internal fixation was performed. Retrospectively the postoperative x-ray demonstrated insufficient reduction. Subsequently the patient reported persisting pain in the lateral aspect of the knee during weight bearing, especially when applying rotational motion. Malunion with bony defect and joint incongruence was confirmed by CT-scan (Fig. 2). The defect measured 28 x 22 x 8 mm and was located in the central aspect of the lateral tibial plateau. Due to the patients young age, a still intact femoral articular surface, a stable knee and a neutral leg alignment we indicated a joint reconstruction with a fresh tibial OAT including the lateral meniscus. At 6mt follow-up the patient was pain free with full flexion and a 5° lack of extension (compared to the the contralateral side). X-ray and MRI showed a good osteointegration of the allograft without any signs of collaps.
At 6mt follow-up the patient was pain free with full flexion and a 5° lack of extension (compared to the the contralateral side). X-ray and MRI showed a good osteointegration of the allograft without any signs of collaps.