Clinical, radiological and histological evaluation of biphasic calcium phosphate bioceramic wedges filling medial high tibial valgisation osteotomies

• Published in: The knee Vol. 16; no. 5; pp. 392 - 397
• Main Authors: Rouvillain, J.L, Lavallé, F, Pascal-Mousselard, H, Catonné, Y, Daculsi, G
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2009; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Arthritis; Biomaterial; Biphasic calcium phosphate bioceramic; Bone Plates; Bone Screws; Bone Substitutes; Calcium; Calcium Phosphates - analysis; Ceramics; Consolidation; Female; Filler materials; Fourier transforms; High tibial valgisation osteotomy (HTVO); Histology; Humans; Knee Joint - diagnostic imaging; Knee Joint - physiopathology; Knee Joint - surgery; Male; Middle Aged; Orthopedics; Osseointegration; Osteotomy - instrumentation; Osteotomy - methods; Personal relationships; Plate and locking screw; Prospective Studies; Radiography; Scanning electron microscopy; Tibia - diagnostic imaging; Tibia - surgery; Tibia - ultrastructure; Varus knee; Biomaterial; Arthritis; High tibial valgisation osteotomy (HTVO); Varus knee; Biphasic calcium phosphate bioceramic; Plate and locking screw
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2008.12.015

Abstract We report clinical, radiological and histological findings following high tibial valgisation osteotomy (HTVO) using micro–macroporous biphasic calcium phosphate wedges fixed with a plate and locking screws. From 1999 to 2002, 43 knees were operated on and studied prospectively. All underwent clinical and radiological follow-up at days 1, 90, and 365 to evaluate consolidation and bone substitute interfaces. Additionally, biopsies were taken for histology at least 1 year after implantation from 10 patients who requested plate removal. Radiologically, consolidation was observed in 98% of cases. At 1 year, correction was unchanged in 95% of cases. Histological analysis revealed considerable MBCP® resorption and bone ingrowth, both into the pores and replacing the bioceramic material. Polarised light microscopy confirmed normal bony architecture with trabecular and/or dense lamellar bone growth at the expense of the wedge implants. X-ray and micro-CT scan revealed a well organised and mineralised structure in the newly-formed bone. This study shows that using MBCP® wedges in combination with orientable locking screws and a plate is a simple, safe and fast surgical technique for HTVO. The is the first study to examine the results by histological analysis, which confirmed good outcomes.