Oh Kwang-Jun, Ko Young-Bong, Jaiswal Sagar, Whang In-Cheul
Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Whangincheul Orthopaedic Clinic Surgery, Gyeonggi Province, Republic of Korea.
J Mater Sci Mater Med. 2016 Dec;27(12):179. doi: 10.1007/s10856-016-5795-1. Epub 2016 Oct 18.
The purpose of this study was to compare the osteoconductivity, and absorbability of hydroxyapatite or beta-tricalcium phosphate in clinical scenario of opening wedge high tibial osteotomy Total 41 knees of 40 patients with follow up period of more than 1 year were enrolled. These patients were divided into two groups, Group I (22 knees, 21 patients) used hydroxyapatite and Group II (19 knees, 19 patients) used beta-tricalcium phosphate as a substitute in the opening gap. According to proven method, the osteoconductivity was assessed radiographically by the extent of new bone formation at osteotomy space and absorbability was evaluated by measuring the area occupied by substitute at immediate postoperative, postoperative 6 months and 1 year. Regarding preoperative demographic data, no significant differences were found between two groups. No statistically significant differences were found between two groups regarding lower limb alignment (mechanical femorotibial angle, weight-bearing line%) and posterior tibial slope at postoperative and final follow up radiographs. Concerning the osteoconductivity, there were no significant differences between two groups in any zone. However, the absorption rate was significantly greater in the Group II than in Group I at 6 months (Group I: 13.7 ± 6.8, group II: 35.3 ± 15.8, P = 0.001) and 1 year (Group I: 24.2 ± 6.3, Group II: 49.6 ± 14.3, P < 0.0001). The complications related to bone substitutes were not observed. Both hydroxyapatite and beta-tricalcium phosphate showed satisfactory gap healing without complications and can be successfully used as alternative healing materials in opening wedge high tibial osteotomy. Our study showed that beta-tricalcium phosphate has superior absorbability than hydroxyapatite. But osteoconductivity showed no significant difference.
本研究的目的是在开放楔形高位胫骨截骨术的临床情况下比较羟基磷灰石和β-磷酸三钙的骨传导性和可吸收性。共纳入40例患者的41个膝关节,随访时间超过1年。这些患者被分为两组,第一组(22个膝关节,21例患者)使用羟基磷灰石,第二组(19个膝关节,19例患者)使用β-磷酸三钙作为开放间隙的替代物。根据已证实的方法,通过截骨间隙处新骨形成的程度进行X线评估骨传导性,并通过测量术后即刻、术后6个月和1年时替代物所占面积来评估可吸收性。关于术前人口统计学数据,两组之间未发现显著差异。在术后和最终随访X线片上,两组在下肢对线(机械性股胫角、负重线%)和胫骨后倾方面均未发现统计学显著差异。关于骨传导性,两组在任何区域均无显著差异。然而,在6个月时,第二组的吸收率显著高于第一组(第一组:13.7±6.8,第二组:35.3±15.8,P = 0.001),在1年时也是如此(第一组:24.2±6.3,第二组:49.6±14.