Resorbability of rigid beta-tricalcium phosphate wedges in open-wedge high tibial osteotomy: a retrospective radiological study

Knee. 2008 Jun;15(3):201-5. doi: 10.1016/j.knee.2008.02.005. Epub 2008 Apr 14.

Abstract

The open-wedge high tibial osteotomy (OWHTO) is a well accepted treatment modality for patients with osteoarthritis of the medial compartment associated with genu varum. To fill in the osteotomy gap 30% macroporosity rigid beta-tricalcium phosphate (beta-TCP) is frequently used as a stable resorbable bone substitute. However, the resorbability of these beta-TCP wedges is not known. The aim of this study was to investigate this. Twenty-one OWHTO procedures in seventeen patients were performed with the use of 30% macroporosity rigid beta-TCP wedges. The osteotomies were fixed using an angle-stable locking plate. Conventional AP and lateral radiographs were examined in order to assess the resorbability of the 30% macroporosity rigid beta-TCP wedges as a function of time. A radiological classification system consisting of five phases was used to monitor the resorption of the 30% macroporosity rigid beta-TCP wedges. The mean duration of follow-up was 62 months (+/-23 range of 28-99). In all 21 cases, remnants of the 30% macroporosity rigid beta-TCP wedges were still present at maximum follow-up. Although the boundaries between 30% macroporosity rigid beta-TCP wedges and bone remained slightly visible, all osteotomies were completely consolidated and full osseointegration took place. In 16 out of 21 knees the fixation system was removed after a mean duration of 32 months (+/-19 range of 6-62). In six out of 21 knees a conversion to a knee arthroplasty was performed after a mean duration of 56 months (+/-18 range of 37-82). The OWHTO did not interfere with the placement of knee prostheses. Complete resorption of 30% macroporosity rigid beta-TCP wedges did not take place up to 8 years after operation.

MeSH terms

  • Adolescent
  • Adult
  • Arthroplasty, Replacement, Knee
  • Bone Plates
  • Bone Substitutes*
  • Calcium Phosphates*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Osseointegration*
  • Osteoarthritis, Knee / surgery
  • Osteotomy*
  • Postoperative Complications
  • Radiography
  • Retrospective Studies
  • Tibia / diagnostic imaging
  • Tibia / surgery*

Substances

  • Bone Substitutes
  • Calcium Phosphates
  • beta-tricalcium phosphate