Hanke Alexander, Bäumlein Martin, Lang Siegmund, Gueorguiev Boyko, Nerlich Michael, Perren Thomas, Rillmann Paavo, Ryf Christian, Miclau Theodore, Loibl Markus
Department of Orthopaedic Trauma Surgery, Spital Davos, Davos, Switzerland; Department of Trauma Surgery, Regensburg University Medical Center, Regensburg, Germany.
Department of Orthopaedic Trauma Surgery, Spital Davos, Davos, Switzerland; Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany.
Injury. 2017 Dec;48(12):2807-2813. doi: 10.1016/j.injury.2017.10.030. Epub 2017 Oct 19.
Synthetic bone grafts (SBGs) are widely used to fill bone defects after fracture reduction. This study assessed the long-term resorption of two different calcium phosphate products (A=ChronOS™ inject and B=Norian SRS; both DePuy Synthes, Oberdorf, Switzerland) used in the surgical treatment of tibial plateau fractures.
Long-term clinical and radiologic follow-up of 52 patients after surgical treatment of intraarticular tibial plateau fractures augmented with SBGs.
The study was performed at a level 3 trauma center.
Between January 2000 and December 2006 a total of 52 patients with intraarticular tibial plateau fractures were operatively treated and augmented with SBGs consisting of a Brushite matix with β-TCP granules (SBG A) or hydroxylapatite with 4-6% carbonate content (SBG B). 46 patients could be contacted and 38 were included in the study. Half of the patients received SBG A and the other half SBG B.
Loss of reduction and SBG resorption was investigated by comparison of follow-up X-ray images to pre- and postoperative X-ray images. Furthermore, pain, activity level and knee function were evaluated by means of questionnaires and clinical examination.
The mean age of patients was 59.7±12.5years. The follow-up was 8.6±0.9years for SBG A and 11.6±1.4years for SBG B (p<0.001). In most cases SBG A was completely resorbed in a homogenous pattern, while SBG B was still visible on the X-ray images revealing a peripheral resorption pattern. A loss of reduction (>2mm) could be observed in two patients with SBG A and two patients with SBG B, although only one of them had an impaired knee function.
The composite SBG A reveals a comprehensive long-term resorption in comparison to SBG B. Nevertheless, both provided suitable mechanical support as part of the surgical treatment of tibial plateau fractures.
Case series, Level IV.
合成骨移植材料（SBGs）广泛用于骨折复位后填充骨缺损。本研究评估了用于胫骨平台骨折手术治疗的两种不同磷酸钙产品（A = ChronOS™注射剂，B = Norian SRS；均为瑞士奥伯多夫的DePuy Synthes公司生产）的长期吸收情况。
对52例接受SBGs增强治疗的关节内胫骨平台骨折患者进行长期临床和影像学随访。
该研究在一家三级创伤中心进行。
2000年1月至2006年12月期间，共有52例关节内胫骨平台骨折患者接受手术治疗，并使用由透钙磷石基质与β - TCP颗粒组成的SBGs（SBG A）或碳酸盐含量为4 - 6%的羟基磷灰石（SBG B）进行增强治疗。46例患者能够取得联系，38例纳入研究。一半患者接受SBG A，另一半接受SBG B。
通过比较随访X线图像与术前和术后X线图像，研究复位丢失和SBG吸收情况。此外，通过问卷调查和临床检查评估疼痛、活动水平和膝关节功能。
患者的平均年龄为59.7±12.5岁。SBG A的随访时间为8.6±0.9年，SBG B为11.6±1.4年（p<0.001）。在大多数情况下，SBG A以均匀的方式完全吸收，而SBG B在X线图像上仍可见，呈现外周吸收模式。在接受SBG A的2例患者和接受SBG B的2例患者中观察到复位丢失（>2mm），尽管其中只有1例膝关节功能受损。
与SBG B相比，复合SBG A显示出全面的长期吸收。然而，两者作为胫骨平台骨折手术治疗的一部分，都提供了合适的机械支撑。
病例系列，IV级。
