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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Sep 18, 2025; 16(9): 111068
Published online Sep 18, 2025. doi: 10.5312/wjo.v16.i9.111068
Published online Sep 18, 2025. doi: 10.5312/wjo.v16.i9.111068
Outcomes of autologous bone grafts vs bone substitutes in tibial plateau fractures: A meta-analysis
Ali Saad Alshahrani, Fawaz Alanii, Department of Orthopedic Surgery, King Fahad University Hospital, Khobar 34445, Saudi Arabia
Yazan Jumah Alalwani, Ahmed Khaled Almarri, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar 31441, Saudi Arabia
Nihal Mushabb Alqahtani, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11421, Saudi Arabia
Abdullah Shafi D Alanazi, College of Medicine, Northern Border University, Arar 91431, Saudi Arabia
Shatha Saud Alqurashi, College of Medicine, Fakeeh College for Medical Sciences, Jeddah 23323, Saudi Arabia
Deemah Khalid Ghazi, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
Abdullah Musaaed Alsalamah, Qassim Health Cluster, Ministry of Health, Qassim 51921, Saudi Arabia
Rahaf Hamdan Alruwaili, College of Medicine, Aljouf University, Sakaka 42421, Al Jawf, Saudi Arabia
Ahmed Y Azzam, Director of Clinical Research and Clinical Artificial Intelligence, ASIDE Healthcare, Lewes, DE 19958, United States
Co-first authors: Ali Saad Alshahrani and Yazan Jumah Alalwani.
Author contributions: Alshahrani AS designed research, performed research, analyzed data, wrote the paper; Alalwani YJ designed research, performed research, analyzed data, wrote the paper; Alqahtani NM performed research, analyzed data, wrote the paper; Alanazi ASD designed research, performed research, analyzed data, wrote the paper; Almarri AK performed research, analyzed data, wrote the paper; Alqurashi SS performed research, analyzed data, wrote the paper; Ghazi DK designed research, performed research, analyzed data, wrote the paper; Alsalamah AM performed research, analyzed data, wrote the paper; Alruwaili RH performed research, analyzed data, wrote the paper; Azzam AY designed research, performed research, analyzed data, wrote the paper; Alanii F designed research, performed research, analyzed data, wrote the paper.
Conflict-of-interest statement: All authors declare no conflict-of-interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ahmed Y Azzam, Director of Clinical Research and Clinical Artificial Intelligence, ASIDE Healthcare, 16192 Coastal Highway, Lewes, DE 19958, United States.
Received: June 23, 2025
Revised: August 3, 2025
Accepted: August 27, 2025
Published online: September 18, 2025
Processing time: 80 Days and 11.2 Hours
Revised: August 3, 2025
Accepted: August 27, 2025
Published online: September 18, 2025
Processing time: 80 Days and 11.2 Hours
Core Tip
Core Tip: This meta-analysis of seven randomized controlled trials involving 424 patients demonstrates that bone substitutes provide equivalent structural outcomes to autologous bone grafts in tibial plateau fractures while offering significant procedural advantages. The study introduces a novel combined outcome scoring system integrating structural, procedural, and complication domains, revealing bone substitutes reduce blood loss by 70-90 mL and operative time, particularly in Asian populations. Geographic variations showed Western studies had 45% higher secondary collapse risk with autografts. These findings support bone substitutes as viable alternatives across all fracture complexities, challenging the traditional gold standard approach and offering particular benefits in resource-limited settings.