Lateral Unicompartmental Arthroplasty As A Treatment For A Massive Osteochondral Defect In The Lateral Tibial Plateau Of A Young Patient

Introduction Despite the good outcomes achieved through open reduction and internal fixation of lateral tibial plateau fractures, osteochondral defects frequently occur as sequelae in such injuries. Depending on their size and depth, treatment options can range from debridement, microfractures, autologous chondrocyte transplantation, mosaicoplasty, massive allograft or arthroplasty. For large defects and young patients with high functional demand, reconstruction with a massive osteochondral graft is often the recommended option. Arthroplasty is typically reserved for older patients with lower functional demand. Case Report A 35-year-old female patient with septic pseudoarthrosis of the tibial diaphysis and lateral tibial plateau sinking fracture of two years duration after a traffic accident. After reconstruction with a vascularized flap and pedicled vascularized autologous fibular graft, the patient developed valgus deformity of the knee and a massive osteochondral defect on the lateral tibial plateau as a consequence of inadequate treatment of the fracture-sinking injury at that level. Discussion The treatment of voluminous osteochondral defects of the lateral tibial plateau largely depends on the patient's age and functional demand. In young patients with high functional demand, massive osteochondral allografts have shown good results, although they are a technically complex option dependent on graft availability. For patients who cannot undergo surgery, lateral unicompartmental surgery can represent a useful alternative treatment. Conclusion Lateral unicompartmental knee arthroplasty can be a valuable treatment alternative for voluminous osteochondral defects of the lateral tibial plateau in young patients where reconstruction with a massive osteochondral graft is not technically feasible.