Conteduca F, Di Sette P, Iorio R, Caperna L, Argento G, Mazza D, Ferretti A
Orthopaedic Unit and Kirk Kilgour Sports Injury Centre, S. Andrea Hospital, University of Rome Sapienza, Italy.
Orthopaedic Unit and Kirk Kilgour Sports Injury Centre, S. Andrea Hospital, University of Rome Sapienza, Italy.
Knee. 2016 Oct;23(5):763-9. doi: 10.1016/j.knee.2016.04.011. Epub 2016 Jun 11.
The aim of this prospective and randomized study was to evaluate the effectiveness of adding nanohydroxyapatite (NHA) to heterologous bone graft in open wedge high tibial osteotomy (OWHTO) by measuring the bone density of the tibial osteotomy gap.
Twenty-seven patients (26 knees) were operated by OWHTO and randomly divided into two groups: pure graft group, in which the osteotomy gap was filled with only heterologous bone graft; nanohydroxyapatite group, in which the osteotomy gap was filled with heterologous bone graft and NHA. All patients underwent computed tomography (CT) examination within one week after operation (Time 0), and after two months (Time 1) and 12months (Time 2). CT volume acquired Hounsfield Units (HU) were calculated and the mean value of bone density on three planes was measured.
At Time 0, the mineral density of the nanohydroxyapatite group appeared significantly higher compared with the pure graft group, due to the presence of NHA. At Time 1, the mineral density of the nanohydroxyapatite group had decreased relative to Time 0, while in the pure graft group it remained unchanged. At Time 2, the mineral density in the nanohydroxyapatite group had further decreased, reaching values close to the mineral density of normal bone. In contrast, in the pure graft group the mineral density had increased, probably due to the lack of reabsorption of the graft and the development of sclerosis in the osteotomy borders.
The results of the present study show better osseointegration of the heterologous graft when nanohydroxyapatite is added.
这项前瞻性随机研究的目的是通过测量胫骨截骨间隙的骨密度，评估在开放性楔形高位胫骨截骨术（OWHTO）中添加纳米羟基磷灰石（NHA）至异体骨移植材料中的有效性。
27例患者（26个膝关节）接受了OWHTO手术，并随机分为两组：单纯移植组，截骨间隙仅填充异体骨移植材料；纳米羟基磷灰石组，截骨间隙填充异体骨移植材料和NHA。所有患者在术后1周（时间0）、2个月（时间1）和12个月（时间2）时接受计算机断层扫描（CT）检查。计算CT容积获得的亨氏单位（HU），并测量三个平面上的骨密度平均值。
在时间0时，由于NHA的存在，纳米羟基磷灰石组的矿物质密度明显高于单纯移植组。在时间1时，纳米羟基磷灰石组的矿物质密度相对于时间0有所下降，而单纯移植组则保持不变。在时间2时，纳米羟基磷灰石组的矿物质密度进一步下降，接近正常骨的矿物质密度值。相比之下，单纯移植组的矿物质密度有所增加，可能是由于移植材料缺乏再吸收以及截骨边界处出现硬化。
本研究结果表明，添加纳米羟基磷灰石时异体移植材料的骨整合更好。
