Department of Sports Medicine and Joint Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
Knee Surg Sports Traumatol Arthrosc. 2014 Nov;22(11):2763-70. doi: 10.1007/s00167-013-2681-y. Epub 2013 Sep 18.
The purpose of this study was to clinically and radiologically compare the utility, osteoconductivity, and absorbability of hydroxyapatite (HAp) and beta-tricalcium phosphate (TCP) spacers in medial open-wedge high tibial osteotomy (HTO).
Thirty-eight patients underwent medial open-wedge HTO with a locking plate. In the first 19 knees, a HAp spacer was implanted in the opening space (HAp group). In the remaining 19 knees, a TCP spacer was implanted in the same manner (TCP group). All patients underwent clinical and radiological examinations before surgery and at 18 months after surgery.
Concerning the background factors, there were no statistical differences between the two groups. Post-operatively, the knee score significantly improved in each group. Concerning the post-operative knee alignment and clinical outcome, there was no statistical difference in each parameter between the two groups. Regarding the osteoconductivity, the modified van Hemert's score of the TCP group was significantly higher (p = 0.0009) than that of the HAp group in the most medial osteotomy zone. The absorption rate was significantly greater in the TCP group than in the HAp group (p = 0.00039).
The present study demonstrated that a TCP spacer was significantly superior to a HAp spacer concerning osteoconductivity and absorbability at 18 months after medial open-wedge HTO.
Retrospective comparative study, Level III.
本研究旨在临床和影像学上比较羟基磷灰石（HAp）和β-磷酸三钙（TCP）间隔物在胫骨高位截骨术（HTO）中的应用、成骨作用和吸收能力。
38 例患者接受了锁定钢板的内侧开放楔形HTO。在前 19 例膝关节中，植入了 HAp 间隔物（HAp 组）。在其余 19 例膝关节中，以同样的方式植入了 TCP 间隔物（TCP 组）。所有患者均在术前和术后 18 个月进行了临床和影像学检查。
就背景因素而言，两组之间没有统计学差异。术后，每组的膝关节评分均显著改善。关于术后膝关节对线和临床结果，两组各参数之间无统计学差异。就成骨作用而言，TCP 组改良的 van Hemert 评分在最内侧截骨区明显高于 HAp 组（p = 0.0009）。TCP 组的吸收率明显高于 HAp 组（p = 0.00039）。
本研究表明，在胫骨高位截骨术后 18 个月时，TCP 间隔物在成骨作用和吸收能力方面明显优于 HAp 间隔物。
回顾性比较研究，III 级。
