Background

Our objective was to assess clinical and radiological findings following a medial opening wedge high tibial osteotomy using a biphasic calcium phosphate (BCP) synthetic bone substitute, designed as a wedge with two differing zones of density. The in-vivo behaviour of this type of bone substitute over time is currently unknown.

Hypothesis

Our hypothesis was that BCP synthetic bone would facilitate bone union and undergo replacement with host bone over the study period.

Patients and methods

Fifteen sequential patients were followed prospectively for minimum 4-years post-operatively. All patients were evaluated clinically using patient reported outcome measures and radiologically to evaluate alignment with maintenance of the osteotomy correction, and bone union with expected BCP dissolution.

Results

All patients had good clinical scores with no reported complications at 4 years. In all cases there were radiographic findings of bone union with consolidation and no loss of correction. However the graft remained densely radiopaque at final follow-up.

Discussions

This study demonstrates that a BCP graft in combination with a locking plate for a medial opening wedge HTO allows early weight-bearing, maintains correction and provides good clinical outcomes. Whilst higher densities of BCP are strong, they do not resorb fully, remaining radiographically visible. This may have implications for the performance of a future knee arthroplasty and caution should therefore be taken.

中文翻译：

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双相磷酸钙骨替代物在内侧开口楔形高位胫骨截骨术中的结果。

背景

我们的目标是使用双相磷酸钙（BCP）合成骨替代物（设计为具有两个不同密度区域的楔形物）评估内侧开口楔形高位胫骨截骨术后的临床和放射学发现。目前尚不知道这种类型的骨替代物随时间的体内行为。

假设

我们的假设是，在研究期间，BCP合成骨将促进骨结合并接受宿主骨替代。

患者和方法

连续随访15例患者，术后至少4年。使用患者报告的结局指标对所有患者进行临床评估，并通过放射学评估与维持截骨术矫正的对齐方式以及预期的BCP溶解情况下的骨结合。

结果

所有患者在4年时均具有良好的临床评分，无并发症报告。在所有情况下，均具有骨结合的影像学表现并伴有巩固，且无矫正损失。但是，在最后的随访中，移植物仍保持不透射线。

讨论区

这项研究表明，BCP移植物与用于内侧开口楔形HTO的锁定板相结合，可使早期负重，保持矫正并提供良好的临床效果。虽然BCP的密度较高，但它们不能完全吸收，在射线照相中仍然可见。这可能对将来的膝关节置换术的表现有影响，因此应谨慎行事。