Lateral hinge fracture delays healing of the osteotomy gap in opening wedge high tibial osteotomy with a beta-tricalcium phosphate block.


Journal

The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 28 07 2019
revised: 02 10 2019
accepted: 28 10 2019
pubmed: 31 12 2019
medline: 29 5 2020
entrez: 30 12 2019
Statut: ppublish

Résumé

The purpose of this study was to investigate the healing process of synthetic bone grafts in opening wedge high tibial osteotomy (OWHTO) and to identify the factors that affect bone healing in OWHTO. It was hypothesized that lateral hinge fracture (LHF) is associated with delayed bone healing after OWHTO with synthetic bone grafting. The subjects included 350 knees of 283 patients who underwent OWHTO using two wedged blocks of beta-tricalcium phosphate (β-TCP) with 60% porosity. The healing of the osteotomy gap using a radiologic rating system for OWHTO with synthetic bone grafts and the presence of an LHF were assessed up to postoperative 24 months. LHFs were found in 49 knees (14%). The osteotomy gap showed slower progression of radiographic healing with an LHF than without an LHF (P < .05). In the knees with LHFs, initial radiographic change in the osteotomy gap was observed almost at the same time as healing of the LHF. Multivariate logistic regression analysis identified LHF as the factor preventing the progression of bone healing (OR = 46.78, P < .05). LHF is associated with delayed bone healing after OWHTO with synthetic bone grafting.

Sections du résumé

BACKGROUND BACKGROUND
The purpose of this study was to investigate the healing process of synthetic bone grafts in opening wedge high tibial osteotomy (OWHTO) and to identify the factors that affect bone healing in OWHTO. It was hypothesized that lateral hinge fracture (LHF) is associated with delayed bone healing after OWHTO with synthetic bone grafting.
METHODS METHODS
The subjects included 350 knees of 283 patients who underwent OWHTO using two wedged blocks of beta-tricalcium phosphate (β-TCP) with 60% porosity. The healing of the osteotomy gap using a radiologic rating system for OWHTO with synthetic bone grafts and the presence of an LHF were assessed up to postoperative 24 months.
RESULTS RESULTS
LHFs were found in 49 knees (14%). The osteotomy gap showed slower progression of radiographic healing with an LHF than without an LHF (P < .05). In the knees with LHFs, initial radiographic change in the osteotomy gap was observed almost at the same time as healing of the LHF. Multivariate logistic regression analysis identified LHF as the factor preventing the progression of bone healing (OR = 46.78, P < .05).
CONCLUSIONS CONCLUSIONS
LHF is associated with delayed bone healing after OWHTO with synthetic bone grafting.

Identifiants

pubmed: 31883759
pii: S0968-0160(19)30253-4
doi: 10.1016/j.knee.2019.10.027
pii:
doi:

Substances chimiques

Biocompatible Materials 0
Bone Substitutes 0
Calcium Phosphates 0
beta-tricalcium phosphate 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

192-197

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no conflict of interest.

Auteurs

Ken Kumagai (K)

Department of Orthopaedic Surgery, Yokohama City University Hospital, Yokohama, Japan. Electronic address: kumagai@yokohama-cu.ac.jp.

Shunsuke Yamada (S)

Department of Orthopaedic Surgery, Yokohama City University Hospital, Yokohama, Japan.

Shuntaro Nejima (S)

Department of Orthopaedic Surgery, Yokohama City University Hospital, Yokohama, Japan.

Shuntaro Muramatsu (S)

Department of Orthopaedic Surgery, Yokohama City University Hospital, Yokohama, Japan.

Yasushi Akamatsu (Y)

Department of Orthopaedic Surgery, Yokohama City University Hospital, Yokohama, Japan.

Yutaka Inaba (Y)

Department of Orthopaedic Surgery, Yokohama City University Hospital, Yokohama, Japan.

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Classifications MeSH