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The efficacy of porous hydroxyapatite chips as gap filling in open-wedge high tibial osteotomy in terms of clinical, radiological, and histological criteria

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Author(s)
Sung-Sahn LeeSang-Yeon SoEui-Yub JungMinkyu Seo Byung Hoon Lee Hyeongchan Shin Joon Ho Wang 
Keimyung Author(s)
Shin, Hyeong Chan
Department
Dept. of Pathology (병리학)
Journal Title
Knee
Issued Date
2020
Volume
27
Issue
2
Keyword
High tibial osteotomyHistologyHydroxyapatite
Abstract
Purpose:
Hydroxyapatite (HA) does not fully degrade, which raises concerns about poor remodeling and incorporation into the bone after open-wedge high tibial osteotomy (HTO). The purpose of this study was to compare the results between gap filling with allogenous chip bone and HA chip after open-wedge HTO using propensity score matching and to analyze the radiological unabsorbed area of opening gaps histologically in HA using patients.

Methods:
The matched variables were age, body mass index, sex, correction angle, and smoking status. After matching, the allogenous group and HA group included 33 patients each with two years of follow-up. The range of motion (ROM), International Knee Documentation Committee (IKDC) subjective score, Knee Injury and Osteoarthritis Outcome Score (KOOS), mechanical axis (MA), tibial slope, osteoconductivity, and absorbability were evaluated and compared between both groups. Among the HA group, 20 patients underwent bone biopsy and histologically analyzed of the radiological unabsorbed area.

Results:
The postoperative ROM, IKDC subjective score, and KOOS were similar in both groups. The osteoconductivities did not differ significantly. The absorbability in the HA group was significantly lower than allogenous group (59.6% vs. 22.6%, P < .001). The histological sections of the radiological unabsorbed area showed mature lamelliform bone tissues were significantly greater than structurally degraded remnant HA (30.4% and 4.2%, P < .001).

Conclusion:
The HA chips showed an inferior absorbability, however, a mature lamelliform bone was observed in significantly larger amounts than remnant HA in the radiological unabsorbed area. The allogenous bone chips and HA chips showed similar clinical and radiological results after open-wedge HTO.
Keimyung Author(s)(Kor)
신형찬
Publisher
School of Medicine (의과대학)
Citation
Sung-Sahn Lee et al. (2020). The efficacy of porous hydroxyapatite chips as gap filling in open-wedge high tibial osteotomy in terms of clinical, radiological, and histological criteria. Knee, 27(2), 436–443. doi: 10.1016/j.knee.2019.12.008
Type
Article
ISSN
1873-5800
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0968016019303199
DOI
10.1016/j.knee.2019.12.008
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43214
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
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