Open AccessA novel evaluation system to monitor bone formation and β‐tricalcium phosphate resorption in opening wedge high tibial osteotomy
Author(s) -
Tanaka T.,
Kumagae Y.,
Chazono M.,
Kitasato S.,
Kakuta A.,
Marumo K.
Publication year - 2015
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-014-2870-3
Subject(s) - hounsfield scale , resorption , medicine , porosity , cancellous bone , nuclear medicine , materials science , biomedical engineering , computed tomography , radiology , surgery , pathology , composite material
Purpose The aim of this study was to establish an evaluation system to monitor bone formation and beta‐tricalcium phosphate (TCP) resorption in opening high tibial osteotomy (HTO). Methods From 2003 to 2005, opening HTO was performed in 36 patients using a Puddu plate and β‐TCP blocks with 60 and 75 % porosity. Thirty‐one patients were used for evaluation. All patients underwent CT examination at 2 weeks and 6 years. The CT image data were divided into three areas, and CT values of each area were analysed using the imaging software, Osirix. Results CT image analysis at 2 weeks showed that the mean CT‐attenuation values (in Hounsfield units) of the implanted area with β‐TCP of 60 % porosity, the implanted area with β‐TCP of 75 % porosity, and cancellous bone were, 1,694.0 ± 94.2, 1,010.9 ± 81.1, and 178.0 ± 45.1, respectively. Six years after surgery, these values were 574.1 ± 273.5, 168.8 ± 75.1, and 174.9 ± 69.3, respectively. Conclusion β‐TCP with 75 % porosity was completely resorbed and replaced by bone. β‐TCP with 60 % porosity was resorbed, but approximately 1/3 still remained even 6 years after surgery. The imaging software, Osirix, enabled scanning of the whole area to measure CT values. This system is the first to quantitatively evaluate β‐TCP resorption and bone formation in opening HTO. Level of evidence Laboratory studies.