Does nanohydroxiapatite promote bone healing in open wedge high tibial osteotomy? A long term CT study
ESSKA Academy. Conteduca F. 11/08/19; 286386
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Does nanohydroxiapatite promote bone healing in open wedge high tibial osteotomy? A long term CT study

EKA Free Papers

Topic: HTO

Conteduca F., Caperna L., Drogo P., Andreozzi V., Ferretti A.
La Sapienza University of Rome, Sant Andrea Hospital, Rome, Italy

Introduction: Healing of bone graft used to fill the osteotomy gap in open wedge high tibial osteotomy (OWHTO) is an important issue. The purpose of this study is to evaluate the effectiveness of adding Nanohydroxyapatite (nHA) to heterologous bone graft by measuring bone density of tibial osteotomy gap.
Methods: We randomized 16 consecutive patients, homogeneous for sex, age and size of aperture gap, undergoing OWHTO into 2 groups: Group A (8 patients), the osteotomy gap was filled with only heterologous bone graft, Group B (8 patients) with heterologous bone graft and nHA. All patients underwent multislice CT examination
to assess the degree of integration of bone grafts at a mean 3 years follow-up. Classification by Van Hemert was used to evaluate bone healing. With this classification we were able to determine in which phase of healing the bone graft was supposed to be. Phase 1 is an early vascular healing with clear distinction between normal bone density and the mineral density of the graft while phase 5 represent complete osteointegration. All patients were also clinically evaluated with WOMAC score and Knee society score (KSS).
Results: The mineral density (MD) of Group A (296,8 + 81,8 HU) was significantly higher compared with Group B (202,2 + 45 HU)(p< 0,05) due to the presence of nHA. Normal bone density was calculated on the contralateral limb in all patients (110,2 + 11,7HU). Considering Van Hemert classification 4 patients in group A resulted in Phase 1 while 4 patients were in Phase 2. In the nHA group (Group B) 3 patients were in phase 3 and 5 patients were in phase 4. WOMAC score for Group A was 92,1 while for Group B was 87,9. KSS score for Group A was 92,7while for Group B was 94,6.
Discussion and conclusion: The data and the analysis of the images suggest a better osteointegration of the heterologous graft when the nanohydroxyapatite is added at a long-term follow-up.
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