Porous Granules Research Articles

Porous Titanium Granules in Treatment of Intra-bony Defects: A Literature Review

Porous Titanium Granules in Treatment of Intra-bony Defects: A Literature Review

Fabrication and cellular biocompatibility of porous spherical calcium phosphate nanoceramic granules

Event Abstract Back to Event Fabrication and cellular biocompatibility of porous spherical calcium phosphate nanoceramic granules Xiangfeng Li1, Yumei Xiao1, Xiangdong Zhu1, Yujiang Fan1 and Xingdong Zhang1 1 National Engineering Research Center for Biomaterials, Sichuan University, China The calcium phosphate ceramic granules have been widely applied to fill irregular shaped bone defects in clinic due to their good biocompatibility, osteoconductivity, and osteoinductivity. In this work, we fabricated porous spherical calcium phosphate (Ca-P) nanoceramic granules with the assistance of sodium alginate and microwave hybrid sintering. Scanning electronic microscopy (SEM), X-ray diffraction (XRD), Fourier transformed infrared spectroscopy (FT-IR), BET and mercury intrusion tests were employed to characterize the Ca-P nanoceramic granules. The SEM images revealed that grain size of the ceramic granules was on the nanoscale. The XRD and FT-IR results certified the phase composition of the Ca-P nanoceramic granules. The BET and mercury intrusion tests demonstrated that the porous spherical Ca-P nanoceramic granules had relatively high specific surface area and interconnected porous structure. Subsequently, the protein adsorption ability and cytocompatibility of porous spherical Ca-P nanoceramic granule were investigated. The obtained Ca-P nanoceramic granules show high ability of adsorbing proteins which implied that the granules might possess good osteoinductivity. Meanwhile, the porous nanoceramic granules could promote better cell adhesion, proliferation and differentiation compared with the conventional ones. Due to the relatively high porosity, nano-level surface topography, high specific surface area and protein adsorbing ability, interconnecting pore structure with abundant micropores and good cytocompatibility, the porous Ca-P nanoceramic spheres have potential to be a good candidate for bone defect filling materials. National Basic Research Program of China (2011CB606201); National Natural Science Foundation of China (81190131); National Sci & Tech Support Plan of China (2012BAI17B01); National Sci & Tech Support Plan of China (2012BAI42G00)

Preparation of Porous Periclase Ceramic

Methods are compared for preparing porous periclase ceramic. The filler used is electromelted periclase and porous periclase granules, and the additives for burning off are sawdust and urea granules. The effect of filler grain size composition, form and amount of sintering, and burnt-off additive on ceramic porosity, strength, and gas permeability are studied.

A Monolithic Carbon Foam-Supported Pd-Based Catalyst towards Ethanol Electro-Oxidation in Alkaline Media

Typically, porous carbon granules, such as activated carbons and graphene sheets, are used as supporting materials to promote the catalytic activity of metallic catalysts. Herein, we report to apply one novel kind of carbon materials, carbon foam with a honeycomb-type open cell structure, as a promising monolithic support. The as-proposed carbon foam-supported Pd-based nanocatalysts are successfully fabricated by the layer-reduction method, and characterized by different physicochemical methods. Experimental results demonstrate that the Pd-based catalysts with a particle size around 4.0 nm are well dispersed on the surface of the cell wall in the carbon foam, and in contrast to the conventional Pd/C, the Pd/CF catalysts show better electrocatalytic activity toward the EOR in alkaline media. It is also found that the Pd1Ni2/CF catalyst shows the best catalytic activity and stability for the EOR, with the onset potential 90 mV more negative than that of Pd/CF, and the peak mass activity 2.8 times higher than that of Pd/CF.

Hierarchical Porous Acetylene Black/ZnFe2O4@Carbon Hybrid Materials with High Capacity and Robust Cycling Performance for Li-ion Batteries

A hierarchical porous acetylene black/ZnFe2O4@carbon hybrid material is prepared by direct thermal decomposition of a mixture of Zn-Fe-oleate complex mixed with acetylene black and subsequent calcination that promotes the conversion reaction to generate ZnFe2O4 nanoparticles. In the hybrid structure, well-dispersed ZnFe2O4 nanoparticles are anchored on the acetylene black substrate and these nanocomposites are further covered and interlinked by amorphous carbon layer, resulting in self-assembly into large hierarchical porous granules. Utilization of the conductive carbon in the nanocomposite can enable better electrons transfer. In addition, this unique structure effectively prevents the aggregation of the ZnFe2O4 nanoparticles and buffers the large volume change of the active material as well as avoiding undesired side effect of the electrode. The hierarchical porous acetylene black/ZnFe2O4@carbon nanocomposite exhibits favorable electrochemical performance, including high reversible capacity retention, good cycling stability, and high rate performance, which suggests that this rational hybrid material has alluring prospect for superior Li-ion batteries.

Antibiotic-loaded Sr-doped porous calcium phosphate granules as multifunctional bone grafts

Multifunctional porous calcium phosphate granules intended as osseous fillers and drug carriers were designed. Strontium- and magnesium- co-substituted biphasic hydroxyapatite (HA)/β-tricalcium phosphate powders (TCP) with compositions close to the mineral part of human bone [(Ca+Sr+Mg)/P=1.62] were prepared by precipitation, heat treated and deagglomerated, and characterized by XRD and SEM. Highly concentrated aqueous suspensions (up to 60vol%) were prepared from the powders heat treated at 1000°C. Starch was added as pore forming agent and the suspensions were dripped into a setting sodium alginate solution to obtain spherical granules. Drying and sintering enabled obtaining porous granules that were impregnated with an antibiotic solution (levofloxacin), frozen and then lyophilized. The drug release profile was then assessed in vitro by UV spectrophotometry, with the best release profile being obtained for the Sr-doped granules. The granules׳ osteocompatibility was evaluated using a pre-osteoblastic cell line. The Sr-doped granules exhibited the highest proliferation yields and efficiency in osteoblastic maturation, including acquisition of a differentiated morphology and high levels of secreted alkaline phosphatase. The microstructural features and the in vitro performance of the granules make them promising multifunctional materials for applications in tissue engineering as antibiotic-loaded bone grafts.

Assessment of activated porous granules on implant fixation and early bone formation in sheep

SummaryBackground/ObjectiveDespite recent progress in regeneration medicine, the repair of large bone defects due to trauma, inflammation and tumor surgery remains a major clinical challenge. This study was designed to produce large amounts of viable bone graft materials in a novel perfusion bioreactor to promote bone formation.MethodsCylindrical defects were created bilaterally in the distal femurs of sheep, and titanium implants were inserted. The concentric gap around the implants was randomly filled either with allograft, granules, granules with bone marrow aspirate (BMA) or bioreactor activated granule (BAG). The viable BAG consisted of autologous bone marrow stromal cells (BMSCs) seeded upon porous scaffold granules incubated in a 3D perfusion bioreactor for 2 weeks prior to surgery. 6 weeks after, the bone formation and early implant fixation were assessed by means of micro-CT, histomorphometry, and mechanical test.ResultsMicroarchitectural analysis revealed that bone volume fraction and trabecular thickness in the allograft were not statistically different than those (combination of new bone and residue of granule) in the other 3 groups. The structure of the allograft group was typically plate-like, while the other 3 groups were combination of plate and rod. Histomorphometry showed that allograft induced significantly more bone and less fibrous tissue in the concentric gap than the other 3 granule groups, while the bone ingrowth to implant porous surface was not different. No significant differences among the groups were found regarding early implant mechanical fixation.ConclusionIn conclusion, despite nice bone formation and implant fixation in all groups, bioreactor activated graft material did not convincingly induce early implant fixation similar to allograft, and neither bioreactor nor by adding BMA credited additional benefit for bone formation in this model.

Synthetic hydroxyapatite in pharmaceutical applications

Synthetic hydroxyapatite plays a key role in implantology, stomatology, and regenerative medicine. Thanks to its non-toxicity and biocompatibility with bone and mineralised dental tissues, it has found application as a bone substitute. The fact that porous granules and scaffolds can be made out of nanocrystalline hydroxyapatite, and that it has a high loading capacity, means that it can be used in pharmaceutical science as a carrier for drugs or a system for controlled drug release. The aim of this study is to present current trends in research on synthetic hydroxyapatite as a carrier for drugs used in the local treatment of bone tissue disorders (multifunction implants) and poorly soluble drugs, including those with limited bioavailability.

Self-organized formation of spherical porous granules only by one-step heat-treatment in MgO–Fe2O3–Nb2O5 system

In this letter, a new process to obtain spherical porous granules (SPGs) is presented, namely self-organized formation only by a one-step heat-treatment. Commercial MgCO3 (basic), α-Fe2O3 and Nb2O5 powders of Mg:Fe:Nb=1:1:1 in mole fraction were wet-ball milled, and were heat-treated in air at 800–1350°C. The samples heated at ≥1100°C, most of the samples became SPGs with the diameter of ∼50–100μm, containing 3-D network structure. The main constituent phase of porous spheres was pseudobrookite-type MgFeNbO5. The formation mechanism of porous microspheres was discussed by using SEM observation and high-temperature XRD analysis.

Reconstruction of Peri-implant Osseous Defects

There is a paucity of data for the effectiveness of reconstructive procedures in the treatment of peri-implantitis. The objective of this study was to compare reconstruction of peri-implant osseous defects with open flap debridement (OFD) plus porous titanium granules (PTGs) compared with OFD alone. Sixty-three patients (36 female, 27 male; mean age 58.4 y [SD 12.3]), contributing one circumferential peri-implant intraosseous defect, were included in a multinational, multicenter randomized trial using a parallel-group design. After OFD and surface decontamination using titanium brushes and hydrogen peroxide, 33 defects received PTGs. The implants were not submerged. All patients received adjunctive perioperative systemic antibiotics. The primary outcome variable (defect fill) was assessed on digitalized radiographs. Clinical measurements of probing depth (PPD), bleeding on probing (BoP), suppuration, and plaque were taken by blinded examiners. After 12 mo, the test group (OFD plus PTG) showed a mean radiographic defect fill (mesial/distal) of 3.6/3.6 mm compared with 1.1/1.0 in the control group (OFD). Differences were statistically significant in favor of the test group (P < 0.0001). The OFD plus PTG group showed a mean reduction in PPD of 2.8 mm compared with 2.6 mm in the OFD group. BoP was reduced from 89.4% to 33.3% and from 85.8% to 40.4% for the test and control groups, respectively. There was no significant difference in complete resolution of peri-implantitis (PPD ≤4 mm and no BoP at six implant sites and no further bone loss), because this finding was accomplished at 30% of implants in the test group and 23% of implants in the control group. Reconstructive surgery using PTGs resulted in significantly enhanced radiographic defect fill compared with OFD. However, limitations in the lack of ability to discern biomaterial from osseous tissue could not be verified to determine new bone formation. Similar improvements according to clinical measures were obtained after both surgical treatment modalities (ClinicalTrials.gov NCT02406001).

Microstructure, physical properties, and bone regeneration effect of the nano-sized β-tricalcium phosphate granules

The nano-sized β-tricalcium phosphate granules for the practical application of bone graft substitutes could be prepared from the wet chemically precipitated β-TCP powders by the liquid–solid mixture route and by controlling the pH of mixture solution to 7.5 within a shorter processing time. The phase purity of prepared β-TCP granules was higher above 99% and their particle sizes ranged from 200 to 650nm. Also, their average compressive strength was higher at 2.22MPa. It is considered that the phase purity, particle refinement, and mechanical compressive strength of β-TCP granules could be significantly improved through the β-TCP powders synthesized through the liquid–solid mixture precipitation at pH of 7.5. Meanwhile both the porosity and the specific surface area positively associated with the osteoconductivity for bone regeneration were higher at 75% and 2.50m2/g respectively due to the nano-sized particles of porous β-TCP granules. Furthermore, the histological analysis in beagle mandibular defect showed that β-TCP granules demonstrated remarkable bone regeneration effectcompared with that of the non-treatment group, indicating the increased new formation of bone (except for callus) (48.42±6.57%) and rapid resorption (69.49±2.40%) without toxicologically significant changes at 12weeks after implantation.

Do Porous Titanium Granule Grafts Affect Bone Microarchitecture at Augmented Maxillary Sinus Sites? A Pilot Split-Mouth Human Study.

The aim of this randomized controlled clinical study was to analyze the bone microarchitecture at augmented maxillary sinus sites by using different materials in patients to compare the effect of porous titanium granules as a sinus augmentation material with bone microstructural features. Eight subjects with bilateral atrophic posterior maxilla of residual bone height <4 mm included in this study and each patient was treated with bilateral sinus augmentation procedure using xenograft with equine origin (Apatos, Osteobiol; Tecnoss Dental) and xenograft (1 g) + porous titanium (1 g) granules (Natix; Tigran Technologies AB). Sixteen human bone biopsy samples were taken from patients receiving two-stage sinus augmentation therapy during implant installation and analyzed using microcomputerized tomography. Three-dimensional bone structural parameters were analyzed in details: tissue volume, bone volume, percentage of bone volume, bone surface and bone surface density, bone specific surface, trabecular thickness trabecular separation, trabecular number, trabecular pattern factor, structural model index, fractal dimension, and bone mineral density. No statistically significant differences were found between groups according to bone structural parameters. Porous titanium grafts may ensure a space for new bone formation in the granules, which may be a clinical advantage for long-term success.

Antibacterial activity and biocompatibility of three-dimensional nanostructured porous granules of hydroxyapatite and zinc oxide nanoparticles—an in vitro and in vivo study

Ceramic scaffolds are widely studied in the bone tissue engineering field due to their potential in regenerative medicine. However, adhesion of microorganisms on biomaterials with subsequent formation of antibiotic-resistant biofilms is a critical factor in implant-related infections. Therefore, new strategies are needed to address this problem. In the present study, three-dimensional and interconnected porous granules of nanostructured hydroxyapatite (nanoHA) incorporated with different amounts of zinc oxide (ZnO) nanoparticles were produced using a simple polymer sponge replication method. As in vitro experiments, granules were exposed to Staphylococcus aureus and Staphylococcus epidermidis and, after 24 h, the planktonic and sessile populations were assessed. Cytocompatibility towards osteoblast-like cells (MG63 cell line) was also evaluated for a period of 1 and 3 days, through resazurin assay and imaging flow cytometry analysis. As in vivo experiments, nanoHA porous granules with and without ZnO nanoparticles were implanted into the subcutaneous tissue in rats and their inflammatory response after 3, 7 and 30 days was examined, as well as their antibacterial activity after 1 and 3 days of S. aureus inoculation. The developed composites proved to be especially effective at reducing bacterial activity in vitro and in vivo for a weight percentage of 2% ZnO, with a low cell growth inhibition in vitro and no differences in the connective tissue growth and inflammatory response in vivo. Altogether, these results suggest that nanoHA–ZnO porous granules have a great potential to be used in orthopaedic and dental applications as a template for bone regeneration and, simultaneously, to restrain biomaterial-associated infections.

A COMPARATIVE STUDY BETWEEN POROUS TITANIUM GRANULES AND NANOCRYSTALLINE HYDROXYAPATITE IN HEALING OF MANDIBULAR DEFECTS IN DOGS

Abstract: Background: Bone grafting is a common technique in Oral and Maxillofacial surgery to replace missing bone. Grafting materials include autografts, allografts, xenografts and synthetic bone substitutes. Two synthetic bone materials are currently available; porous titanium granules and nanocrystalline hydroxyapatite. Objectives: This study compared the use of Porous titanium granules (PTG) versus Nanobone® in healing of mandibular defects in dogs and this was estimated by histological and histomorphometric analysis. Materials and Methods: The study was conducted on 10 healthy experimental dogs. An osseous defect of 10mm depth and 10mm width was created in the premolar area of both right and left sides of the mandible. The right side defects were grafted with PTG while the left side defects were grafted with Nanobone®. Histological and histomorphometrical evaluation was carried out to monitor bone healing and quantify the bone volume with both PTG and Nanobone® at 3, 6 and 12 weeks intervals post-operatively. Results: The mean bone volume value with PTG was 773.4 ± 499.4 on the 3rd week, then increased on the 6th week to be 10125.3 ± 19287.3 and 2676.0 ± 1388.2 on the 12th week. The mean bone volume value with Nanobone® was 525.5 ± 332.1 on the 3rd week, then on the 6th week it became 287.4 ± 322.5. There was a statistically significant increase on the 12th to be 1976.8 ± 1568.1. . There was a statistically significant difference regarding the mean bone volume value between the two groups. Conclusion: Both PTG and Nanobone® have osteoconductive properties and are effective in healing bone defects, but the histomorphometric analysis quantified the bone volume with both PTG and Nanobone® and revealed that the maximum amount of the total regenerated bone was seen in the PTG group; bone was formed within its porosities Key Words: Porous Titanium Granules, Nanobone®, bone defects, bone volume, histomorphometric analysis.

Synthesis of Hydroxyapatite via Sol-Gel Dip-Coating Method on Ceramic Support

Hydroxyapatite (HA) has been used extensively in application of biomedical either in the form of porous ceramics, dense ceramics, powders or granules for gap filling or coatings for implants. Synthetic HA also has an excellent ion exchange properties that used as a filling material for chromatography columns. Furthermore, many researchers have reported that high removal efficiency of the heavy metals can be achieved by using synthetic HA. In this study, HA was synthesized via sol-gel method by using calcium nitrate tetrahydrate and triethyl phosphate as the precursors and 2-metoxiethanol ether as an organic solvent. Then, HA sol was deposited on silica-alumina based ceramics whose made by recycled sanitary ware waste by dip-coating method. The obtained coated substrates were then dried at 150°C and subsequently subjected to calcination up to 1000°C. Fourier Transform Infrared (FTIR) characterization for the HA powders dried at 150°C and calcined at 600°C, 800°C and 1000°C were carried out to come out with the spectral characteristic indicative of chemical bonding. High Purity of the obtained hydroxyapatite was confirmed by XRD analysis. The SEM micrographs displayed the microstructure of the HA coatings.

New Revolutionary Ideas of Material Processing – A Path to Biomaterial Fabrication by Rapid Prototyping

The fundamentally different features of Rapid prototyping (RP) from that of conventional sintering offerus some new approaches to develop materials with excellent properties. Applying this method, porous Hydroxyapatite (Hap) ceramics, as well as the HAp-zirconia composites have been fabricated successfully. Porous hydroxyapatite (Hap) is expected to have desired mechanical and biological properties for biomedical applications. However, due to material processing problems, to date, this material can only be prepared by conventional techniques. Fuse deposition Machine is modified to fabricate Hap conventional support structure is not required three nozzle system is utilized for fabrication. Main nozzle is provided with heating arrangement. Two nozzles provided for transient Hap and solvent. Three stages heating with two lasers arrangement for gradual temperature change so transformation is faster .Primary result shows mechanical properties and porosity is as per bone structure. The micro structural characterizations such as phase purity and composition of porous BCP granules were performed and verified by X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FT-IR) analysis. The chemical and the microstructure information of the Fabricated Hap were investigated by FT-IR (Fourier Transform Infra-Red), SEM (Scanning Electron Microscopy), X-ray Diffraction (XRD). Result shows interconnected regular pores and uniformly distribution of Hap. There is covalent boding makes stronger adhesion to prosthetic. Using this technique, it is possible to produce scaffolds with mechanical and structural properties close to those of the natural bone and teeth. The prepared scaffold has an open, regular pattern and uniformly interconnected porous structure. Some extent problem of small Nano particle aggregate together is called Balling and product of different temperature solidify on the layer is called recasting is dominates the process. By optimizing the operating parameter these problem can be minimized.

The effect of an alginate carrier on bone formation in a hydroxyapatite scaffold.

This study investigated the osteoconductive properties of a porous hydroxyapatite (HA) scaffold manufactured using a novel technique similar to the bread-making process, alone and in combination with an alginate polysaccharide fiber gel (HA/APFG putty) and autologous bone marrow aspirate (BMA). The hypothesis was that the HA/APFG putty would be as osteoconductive as granular HA and that the presence of BMA would further enhance bone formation in an ovine femoral condyle critical defect model. Thirty-six defects were created and either (1) porous HA granules, (2) HA/APFG putty, or (3) HA/APFG putty + BMA were implanted. After retrieval at 6 and 12 weeks, image analysis techniques were used to quantify bone apposition rates, new bone area, bone-HA scaffold contact, and implant resorption. At 6 weeks postsurgery, significantly lower bone apposition rates were observed in the HA/APFG putty group when compared to the HA (p = 0.014) and HA/APFG putty + BMA (p = 0.014) groups. At 12 weeks, significantly increased amounts of new bone formation were measured within the HA scaffold (33.56 ± 3.53%) when compared to both the HA/APFG putty (16.69 ± 2.7%; p = 0.043) and the defects containing HA/APFG putty + BMA (19.31 ± 3.8%; p = 0.043). The use of an APFG gel as a carrier for injectable CaP bone substitute materials delayed bone formation in this model compared to HA granules alone which enhanced bone formation especially within the interconnected smaller pores. Our results also showed that the addition of autologous BMA did not further enhance its osteoconductive properties. Further study is required to optimize the degradation rate of this APFG binding agent before using as a directly injectable material for repair of bone defect. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1328-1335, 2016.

РЕЗУЛЬТАТЫ ЭКСПЕРИМЕНТАЛЬНЫХ ИССЛЕДОВАНИЙ, НАПРАВЛЕННЫХ НА ОЦЕНКУ БИОЛОГИЧЕСКИХ СВОЙСТВ МОДИФИЦИРОВАННЫХ ГРАНУЛ ДИОКСИДА ЦИРКОНИЯ.

Materials for production of dentures and implantation systems have to possess a complex of characteristics among which lack of toxicity in relation to tissues of the patient and bioinertness is obligatory. The purpose of work was development of ceramics on the basis of zirconium dioxide with a further assessment of parameters of acute toxicity, and also research of influence on regeneration of a bone tissue. For the solution of objectives the ceramics on the basis of zirconium dioxide stabilized the 15th pier was developed and received. % cerium dioxide. By results of experiment of an assessment of parameters of acute toxicity it is established that zirconium dioxide nanoparticles in a dose of 8000 mg/kg at single probe introduction don’t cause intoxication phenomena on the level of change of integrated indicators of the general condition of experimental animals. Results of histologic research of tissues of experimental animals revealed dense contact of a coarse-fibered and lamellar bone tissue with porous granules of dioxide of zirconium. Modifying of a surface of granules compounds of calcium and phosphorus, promotes effective process of a reparativny histogenesis of a bone. It provides dense connection with it without signs of development of pathological changes of fabrics in a zone of an arrangement of the implanted material. Thus, there is a possibility of application of granules of dioxide of zirconium in practical stomatology for acceleration and improvement of quality of bone regeneration at a sine lifting with direct installation of a tooth implant; for elimination of defects, a bone tissue, adjacent to an implant, by sealing of bone defects; for building or reconstruction of a bone tissue of maxillofacial area with preservation of high degree of esthetics.

Different bone regeneration patterns in periimplant circumferential gap defects grafted with two types of osteoconductive biomaterial.

This study aimed to determine healing patterns in periimplant gap defect grafted with demineralized bovine bone mineral (DBBM) and porous titanium granules (PTG), which are known to induce a minimal tissue reaction and to undergo minimal biodegradation in healing process. Experiments were performed using a standardized periimplant gap-defect model in dogs with two observational periods: 4 and 8 weeks. Circumferential defects were surgically induced around dental implants on unilateral mandibles in five dogs, and collagen barrier membranes were placed over the DBBM and PTG grafts at two experimental sites and over a nongrafted site. Four weeks later, the same procedures were performed on the contralateral mandible, and the animals allowed to heal for a further 4 weeks, after which they were sacrificed and their mandibles with graft/control sites harvested for histologic evaluation. Both types of grafted biomaterials significantly enhanced the defect fill with newly formed bone, but the bone-to-implant contact (BIC) was significantly increased only at sites that had been grafted with DBBM. The two experimental sites exhibited different healing patterns, with new bone formation being observed on the surface of the DBBM particles throughout the defect, while there was no de novo bone formation on the PTG surface, but rather appositional bone growth from the base and lateral walls of the defect. It has been suggested that gap-defect filling with DBBM around dental implants may enhance both BIC and defect fill; however, the present findings show that defect grafting with PTG enhances only defect fill and not BIC. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1202-1209, 2016.

Porous titanium granules are better than autograft bone as a bone void filler in lateral tibial plateau fractures: A randomised trial.

A total of 20 patients with a depressed fracture of the lateral tibial plateau (Schatzker II or III) who would undergo open reduction and internal fixation were randomised to have the metaphyseal void in the bone filled with either porous titanium granules or autograft bone. Radiographs were undertaken within one week, after six weeks, three months, six months, and after 12 months. The primary outcome measure was recurrent depression of the joint surface: a secondary outcome was the duration of surgery. The risk of recurrent depression of the joint surface was lower (p < 0.001) and the operating time less (p < 0.002) when titanium granules were used. The indication is that it is therefore beneficial to use porous titanium granules than autograft bone to fill the void created by reducing a depressed fracture of the lateral tibial plateau. There is no donor site morbidity, the operating time is shorter and the risk of recurrent depression of the articular surface is less.