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The outcome of biphasic calcium phosphate bone substitute in a medial opening wedge high tibial osteotomy

  • Clinical Applications of Biomaterials
  • Original Research
  • Published:
Journal of Materials Science: Materials in Medicine Aims and scope Submit manuscript

Abstract

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.

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Authors and Affiliations

  1. Sydney Orthopaedic Research Institute, Level 1 The Gallery, 445 Victoria Avenue, Chatswood, NSW, 2067, Australia

    Sven Putnis, Thomas Neri, Antonio Klasan & Myles Coolican

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  1. Sven Putnis
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  2. Thomas Neri
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Correspondence to Sven Putnis.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the local ethics committee (NSLHD HREC RESP/17/110).

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Written informed consent was obtained by each participant prior to commencement of the study.

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Putnis, S., Neri, T., Klasan, A. et al. The outcome of biphasic calcium phosphate bone substitute in a medial opening wedge high tibial osteotomy. J Mater Sci: Mater Med 31, 53 (2020). https://doi.org/10.1007/s10856-020-06391-9

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  • DOI: https://doi.org/10.1007/s10856-020-06391-9

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