Sasaki Sota, Maeyama Akira, Kiyama Takahiko, Kamada Satoshi, Kobayashi Tomohiro, Ishii Satohiro, Yamamoto Takuaki
Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 810-0180, Japan.
Department of Rehabilitation, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 810-0180, Japan.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2022 Jul 5;29:30-34. doi: 10.1016/j.asmart.2022.05.004. eCollection 2022 Jul.
BACKGROUND/OBJECTIVE: Beta-tricalcium phosphate (β-TCP) is often used as a gap filler in open-wedge high tibial osteotomy (OWHTO). The aim of the present study was to investigate the effects of using β-TCP with different porosities on bone remodelling after OWHTO.Methods: We evaluated 29 knees in 26 patients that underwent OWHTO using β-TCP with porosities of 60% and 75% (combined group). A further 30 knees in 28 patients that underwent OWHTO using β-TCP with 60% porosity alone were allocated as a control group. In the combined group, a β-TCP block with 75% porosity was inserted into the gap at the cancellous bone site and a β-TCP block with 60% porosity was inserted into the medial cortical bone side. In the control group, a β-TCP block with 60% porosity was inserted into the osteotomy gap. The bone remodelling phases of the inserted β-TCP blocks were evaluated on standard anteroposterior radiographs using the modified van Hemert classification at 3 and 6 months post-operatively.
The rate of satisfactory bone remodelling at the cancellous bone sites was 86.2% (25/29) in the combined group and 0% (0/30) in the control group at 3 months post-operatively (p<0.05), progressing to 96.6% (28/29) in the combined group and 20% (6/30) in the control group at 6 months post-operatively (p<0.05).
The present study demonstrated that combined use of β-TCP with high and low porosities can significantly enhance bone formation. The combined use of artificial bones with different porosities is useful for early bone remodelling in OWHTO.
背景/目的：β-磷酸三钙（β-TCP）常用于开放性楔形高位胫骨截骨术（OWHTO）中的间隙填充。本研究的目的是探讨使用不同孔隙率的β-TCP对OWHTO术后骨重塑的影响。
我们评估了26例接受OWHTO手术的患者的29个膝关节，这些患者使用了孔隙率为60%和75%的β-TCP（联合组）。另外28例接受OWHTO手术的患者的30个膝关节仅使用孔隙率为60%的β-TCP作为对照组。在联合组中，将孔隙率为75%的β-TCP块插入松质骨部位的间隙，将孔隙率为60%的β-TCP块插入内侧皮质骨侧。在对照组中，将孔隙率为60%的β-TCP块插入截骨间隙。术后3个月和6个月，使用改良的范赫默特分类法在标准前后位X线片上评估插入的β-TCP块的骨重塑阶段。
术后3个月，联合组松质骨部位骨重塑满意率为86.2%（25/29），对照组为0%（0/30）（p<0.05）；术后6个月，联合组升至96.6%（28/29），对照组为20%（6/30）（p<0.05）。
本研究表明，联合使用高孔隙率和低孔隙率的β-TCP可显著促进骨形成。联合使用不同孔隙率的人工骨对OWHTO早期骨重塑有益。
