Tricalcium phosphate granules or rigid wedge preforms in open wedge high tibial osteotomy: a radiological study with a new evaluation system

The capacity of two forms of porous beta-tricalcium phosphate bone substitutes (TCP) to promote bone healing in open wedge high tibial osteotomy (OWHTO) was studied. We reviewed the X-rays of 27 osteotomies, with either TCP wedges or TCP granules as filling material, to compare the bone healing rate...

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Bibliographic Details
Published in:The knee 2004-12, Vol.11 (6), p.451-456
Main Authors: van Hemert, Wouter L.W., Willems, Karel, Anderson, Patricia G., van Heerwaarden, Ronald J., Wymenga, Ate B.
Format: Article
Language:English
Subjects:
Adult
Bone Plates
Bone Regeneration - drug effects
Bone Substitutes - therapeutic use
Calcium Phosphates - therapeutic use
Female
Granules
Humans
Hydroxyapatite
Knee Joint - diagnostic imaging
Knee Joint - surgery
Male
Morbidity
Orthopedic apparatus
Osteoarthritis, Knee - diagnostic imaging
Osteoarthritis, Knee - surgery
Osteotomies
Osteotomy - methods
Radiography
Reproducibility of Results
Surgery
Tibia - diagnostic imaging
Tibia - surgery
Transplants & implants
Treatment Outcome
Tricalcium phosphate
Wedges
Wound healing
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Summary:The capacity of two forms of porous beta-tricalcium phosphate bone substitutes (TCP) to promote bone healing in open wedge high tibial osteotomy (OWHTO) was studied. We reviewed the X-rays of 27 osteotomies, with either TCP wedges or TCP granules as filling material, to compare the bone healing rates and bone remodelling, at specific postoperative intervals. A new radiologic rating system for OWHTO was created and tested for clinical applicability. All osteotomies healed uneventfully and complete resorption of TCP was demonstrated at 1 year postoperative in 85% ( n=23) of the procedures. In 44% ( n=10) of these 23 procedures, the osteotomy site was no longer visible. No difference in bone healing rate and bone remodelling was found when comparing the use of granules to a wedge, and no adverse effects of TCP were observed. The good inter- ( k=0.7) and intraobserver ( k=0.6) reliability of the new radiologic rating system enables clinical use. Good bone healing was found in OWHTO with both wedges and granules of TCP.
ISSN:0968-0160
1873-5800
DOI:10.1016/j.knee.2004.08.004