Introduction: There is no unanimous opinion for the use of grafting agent in the reconstruction of depressed tibial condyle fracture. Autograft is most commonly used filling agent for elvation of depressed tibial condyle fracture. However there are certain limitations which led to a recent attraction toward synthetic bone substitute like crystalline hydroxyl apatite granules and blocks.

In this study, we have compared the functional outcome and complications of autograft and bone graft substitute in reconstruction of depressed tibial condyle fractures.

Materials and Methods: A total of 40 patients with acute tibial condyle fracture were studied. Bone graft substitute and autograft were applied in 20 and 20 cases, respectively. The age of the patients was between 20 to 50 years, and the minimum followup period of patients was 12 months and maximum was 18 months .The Radiological and functional assessment was done using the modified Rasmussen clinical criteria.

Results: A total of two infections were observed, which occurred in patients with Bone graft substitute. Articular surface collapse was seen in three patients, with two bone graft substitute and one autograft patients. The mean clinical score was 18.50 and 18.55 in autograft and allograft received patients, respectively (p = 0.09). The mean radiological score was 15.50 and 15.60 in autograft and bone graft substitute received patients (p = 0.3). In bone graft substitute there was no graft doner site morbity.

Conclusion: While comparing the complication rate, functional and radiological outcome of bone graft substitute versus Autograft reconstruction of TPF, hydroxy apatite allograft could be used as a good alternative of autograft as well.