Santoso Asep, Utomo Pamudji, Mahyudin Ferdiansyah, Utomo Dwikora N, Budhiparama Nicolaas C, Anwar Iwan B, Sibarani Tangkas, Warman Fanny I
Department of Orthopaedic and Traumatology, Sebelas Maret University, - Prof. Dr. R. Soeharso Orthopaedic Hospital, Surakarta, Indonesia.
Department of Orthopaedic and Traumatology, Airlangga University, Dr. Soetomo General Hospital, Surabaya, Indonesia.
Ann Med Surg (Lond). 2023 Jun 17;85(7):3339-3346. doi: 10.1097/MS9.0000000000000972. eCollection 2023 Jul.
High tibial osteotomy is a reliable procedure for the correction of knee varus deformity. An opening-wedge high tibial osteotomy (OW-HTO) is the most popular technique. The results of the bone defect after opening the wedge needed special treatment to ensure bone healing. This study aims to evaluate the use of bovine-derived hydroxyapatite graft for defect filling after OW-HTO.
A retrospective study was performed on all patients who received OW-HTO at Prof. Dr R. Soeharso Orthopaedic Hospital from November 2019 to December 2022. A total of 21 patients (24 knees) were included in this study. Clinical dan radiological evaluation was performed on all patients preoperative and postoperatively. The mean of the follow-up period was 12.6 months with a minimum of 4 months follow-up.
Primary medial uni-compartment knee osteoarthritis was the most common diagnosis, with 17 of 24 cases (70.8%). Mechanical axis deviation was changed from 31 mm medial deviation (range: 8-52 mm) to 0.45 mm medial deviation (range: 13 - (-8) mm). The anatomic tibiofemoral angle was corrected from a preoperative mean of 4.7 of varus to a mean of 5.8 of valgus postoperatively. Bone defect height was mean 15.9 mm with a range of 10-23 mm. Bone defect width was mean 46.7 mm (range: 34-60 mm). Hydroxyapatite graft integration with the host bone was found in all patients during the final follow-up period.
Bovine-derived hydroxyapatite graft is a safe and effective material for bone defect filling in OW-HTO procedures with a high bone union rate.
高位胫骨截骨术是矫正膝内翻畸形的可靠手术。开口楔形高位胫骨截骨术(OW-HTO)是最常用的技术。开口楔形截骨后骨缺损的处理结果需要特殊治疗以确保骨愈合。本研究旨在评估牛源羟基磷灰石移植物在OW-HTO术后骨缺损填充中的应用。
对2019年11月至2022年12月在R. Soeharso教授骨科医院接受OW-HTO手术的所有患者进行回顾性研究。本研究共纳入21例患者(24个膝关节)。对所有患者进行术前和术后的临床及影像学评估。随访期平均为12.6个月,最短随访时间为4个月。
原发性内侧单髁膝关节骨关节炎是最常见的诊断,24例中有17例(70.8%)。机械轴偏差从内侧偏差31毫米(范围:8 - 52毫米)变为内侧偏差0.45毫米(范围:13 - (-8)毫米)。解剖学胫股角从术前平均内翻4.7°矫正为术后平均外翻5.8°。骨缺损高度平均为15.9毫米,范围为10 - 23毫米。骨缺损宽度平均为46.7毫米(范围:34 - 60毫米)。在最后随访期,所有患者均发现羟基磷灰石移植物与宿主骨融合。
牛源羟基磷灰石移植物是OW-HTO手术中用于骨缺损填充的安全有效材料,骨愈合率高。