title: Calcium phosphate cement enhances primary stability of open-wedge high-tibial osteotomies.
abstract: We investigated if injectable calcium phosphate cement improves primary stability in open-wedge high-tibial osteotomy. A 10 mm open-wedge osteotomy was performed on eight pairs of preserved cadaver tibiae and seven pairs of composite (Sawbone) left tibiae. Osteosynthesis was performed with the Dynafix plate system. The gap resulting from surgery either was filled with 15 g injectable calcium phosphate cement in half the bones or was left untreated. The composite tibiae were loaded at a ramp speed of 20 mm/min up to 20 kN. The cadaver tibiae were exposed to 100 cycles with a maximum compressive force of 2,250 N. After 100 cycles of loading with 2,250 N, the final loaded displacement was 1.2 mm for the cadaver tibiae treated with injectable calcium phosphate cement as compared with 3.6 mm for the empty defects (P = 0.028). All the seven empty defect composite specimens failed prior to 20 kN (median 2.8 kN) as compared with five of the injectable calcium phosphate cement specimens (median 17 kN) (P = 0.005). The injection of injectable calcium phosphate cement following open-wedge osteotomy of the proximal tibia increases the initial stability of the bone as measured by load-to-failure and displacement after cyclic loading. Clinical studies are ongoing to investigate whether injectable calcium phosphate cement also has clinical advantage on wedge healing and stability.
authors.affiliation: Orthopaedic Division, North Denmark Region, Aalborg Hospital, Aarhus University Hospital, Sdr. Skovvej 11, 9000 Aalborg, Denmark. tblh@rn.dk
authors.forename: Thomas
authors.initials: T
authors.lastname: Lind-Hansen
authors.forename: Poul Torben
authors.initials: PT
authors.lastname: Nielsen
authors.forename: Juozas
authors.initials: J
authors.lastname: Petruskevicius
authors.forename: Benny
authors.initials: B
authors.lastname: Endelt
authors.forename: Karl Brian
authors.initials: KB
authors.lastname: Nielsen
authors.forename: Ivan
authors.initials: I
authors.lastname: Hvid
authors.forename: Martin
authors.initials: M
authors.lastname: Lind
mesh_terms: D001696:Biomechanical Phenomena; D001843:Bone Cements / Q000627:therapeutic use*; D015519:Bone Density; D002102:Cadaver; D002130:Calcium Phosphates / Q000627:therapeutic use*; D006801:Humans; D010027:Osteotomy / Q000379:methods*; D013977:Tibia / Q000502:physiology* / Q000601:surgery*; D016474:Weight-Bearing
chemical_list: D001843:Bone Cements; D002130:Calcium Phosphates; C020243:calcium phosphate