Tibial plateau fractures are often complex injuries that result from high-energy trauma affecting the articular congruity of the knee. Managing tibial plateau fractures can be challenging because of severe depression of the subchondral cancellous bone and concomitant cartilage injury. Bone substitutes are commonly used to fill such defects as part of the surgical treatment of tibial plateau fractures. We describe three cases of tibial plateau fractures managed with a synthetic bone substitute (b.Bone™, GreenBone ORTHO S.p.A Faenza, Italy) with a highly interconnected and porous 3D structure to mimic the hierarchical architecture and morphology of natural human bone