title: Clinical, radiological and histological evaluation of biphasic calcium phosphate bioceramic wedges filling medial high tibial valgisation osteotomies.
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.
authors.affiliation: Orthopaedic Department, University La Meynard Hospital, 97261 Fort de France, Martinique. jlrouvillain@sasi.fr
authors.forename: J L
authors.initials: JL
authors.lastname: Rouvillain
authors.forename: F
authors.initials: F
authors.lastname: Lavallé
authors.forename: H
authors.initials: H
authors.lastname: Pascal-Mousselard
authors.forename: Y
authors.initials: Y
authors.lastname: Catonné
authors.forename: G
authors.initials: G
authors.lastname: Daculsi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D018786:Bone Substitutes; D002130:Calcium Phosphates / Q000032:analysis; D002516:Ceramics; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016348:Osseointegration; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods; D011446:Prospective Studies; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery* / Q000648:ultrastructure
chemical_list: D018786:Bone Substitutes; D002130:Calcium Phosphates