Effectiveness of bone substitute materials in opening wedge high tibial osteotomy: a systematic review and meta-analysis

Bei, Tao; Liu, Yang; Huang, Qiulin; Wu, Jizhou; Liu, Junting

doi:10.1080/07853890.2022.2036805

Cited by 17 publications

(11 citation statements)

References 52 publications

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“…α′-TCP powder was produced using the same technology [20], needle crystals . This made it possible to avoid the difference in the physical and chemical characteristics of the material, which could affect its behavior in the biological environment in vivo, namely the bone [4,5,7]. CPC is a promising material for filling bone defects: firstly, the liquid form makes it possible to fill cavities of irregular configuration, and secondly, they are related to bone tissue, capable of bioresorption [1,9,14,16].…”

Section: Discussionmentioning

confidence: 99%

“…A recently published meta-analysis [7] determined that materials based on β-TCP in combination with the use of blocked plates can become a safe and effective alternative to the use of autografts during open wedge-shaped high tibial osteotomy (a gap of more than 10 mm) in patients with osteoarthritis of the knee joint, considering in particular, the absence of the need for additional surgical intervention, excessive blood loss, hematoma formation, and pain. However, the authors noted differences in the physicochemical properties of industrial samples of calcium phosphate ceramics from different manufacturers, which is reflected in their ability to biodegrade with replacement by bone tissue [4,5,7] In addition, a difficult task for the developers of calcium-phosphate ceramics is the controlled speed of their resorption and the strength and mechanical reliability necessary for the requirements of orthopedics, which is also determined by the physicochemical structure.…”

Section: Introductionmentioning

confidence: 99%

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Bone Regeneration After Implantation of Calcium Phosphate Cements Based on Metastable Tricalcium Phosphate (In Vivo Experimental Study)

Poplavska¹,

Ashukina²

2023

OTP

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Calcium phosphatCalcium phosphate cement (CPC) is a material used to fill bone defects. Its advantages include being able to fill irregularly shaped spaces, its similarity to bone tissue, and ease of biodegradation. However, insufficient durability and unpredictable rate of resorption limit CPC use. Objective. Study the dynamics of morphological changes in rat femurs after implanting two types of CPC based on metastable αʹ‒tricalcium phosphate(αʹ‒TCP) into defects in the distal metaphysis. Methods. 42 male white rats were used in the study. In each rat, defects were created in the distal metaphysis of the left femur and filled with one of the two types of CPC. The animals were split into two groups: І (n = 21) — CPC based on αʹ‒TCP powder; ІІ (n = 21) — CPС based on αʹ‒TCP powder reinforced with hydroxyapatite (HA) whiskers (4 % mass). Both varieties of CPC were developed and prepared at the Department of Solid-State Physics at the V. N. Karazin Kharkiv National University (Ukraine). 14, 30, and 60 days after the surgery, the animals were sacrificed, and histological analyses were performed. Results. For both types of CPC, inflammation was not observed in the region around the implant at 14, 30, or at 60 days. Bone tissue formed on the surface of the materials. The stages of bone repair were similar to the known stages of bone repair. As a result of the resorption of the CPC, 60 days after surgery the CPC comprised 26.83 % of the area of the defect in group I and 29.93 % in group II. The rest of the area was composed of lamellar bone. The two groups did not differ significantly in rate of CPC resorption or bone tissue formation. Conclusions. The two types of CPC studied, based on αʹ‒TCP (group I) and αʹ‒TCP reinforced with HA whiskers (group II), are biocompatible, osteoconductive, and osteoinductive. In addition, these materials are biodegradable and, with time, are replaced by bone tissue.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bone Regeneration After Implantation of Calcium Phosphate Cements Based on Metastable Tricalcium Phosphate (In Vivo Experimental Study)

Poplavska¹,

Ashukina²

2023

OTP

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“…Furthermore, there remains uncertainty regarding the most suitable selection of a bone-void filler from a range of available materials. [3][4][5][6][7] There is a general consensus that autograft should be considered the "gold standard" for bone regeneration procedures. 8 Autografts have exceptional osteo-conductive and osteo-inductive properties and offer strong structural support.…”

Section: Introductionmentioning

confidence: 99%

“…[11][12][13][14][15][16] These results might have been confounded by factors such as variations in the size of the opening gap, diversities of surgical and fixation techniques, discrepancies in the duration of follow-up, and demographic characteristics. In a metaanalysis of randomized trials, Bei et al 7 found that bone grafting does not offer any benefits for osteotomy gaps smaller than 10 mm. However, they did note potential benefits for gaps larger than 10 mm.…”

Section: Introductionmentioning

confidence: 99%

“…The utilization of bone grafts or bone substitutes to fill the void caused by MOWHTO in the proximal tibia is a subject of ongoing debate. Furthermore, there remains uncertainty regarding the most suitable selection of a bone‐void filler from a range of available materials 3–7 . There is a general consensus that autograft should be considered the “gold standard” for bone regeneration procedures 8 .…”

Section: Introductionmentioning

confidence: 99%

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No Superior Bone Union Outcomes with Allografts Compared to No Grafts and Autografts Following Medial Opening Wedge High Tibial Osteotomy: A Retrospective Cohort Study

Mao,

Yao,

et al. 2023

Orthopaedic Surgery

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ObjectiveThere has been long‐standing debate about whether a medial opening wedge high tibial osteotomy (MOWHTO) gap should be filled with autologous bone graft or any other filler to expedite the healing process. The main purpose of this study was to compare the clinical and radiological outcomes of MOWHTO with an opening gap ≥10 mm, utilizing autograft, allograft, or no graft at 1 year postoperatively.MethodsA total of 68 patients were included in this retrospective study and divided into three treatment groups: Group A (no bone graft), Group B (autologous iliac crest graft), and Group C (allogenous tibia plateau graft). At postoperative 1‐year follow‐up, the area of callus filling in the most medial side of the knee was measured using anteroposterior radiographs, and a modified van Hemert scoring system was used to evaluate bone union outcomes in five mediolaterally divided zones. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and relevant complications were assessed. The correlations between the gap width and bone union scores were evaluated.ResultsPatients in the autograft group demonstrated better bone union progression (p = 0.031) and higher bone union scores (p < 0.01) compared to patients in the allograft or no graft groups. There were no significant differences in terms of postoperative WOMAC scores and incidence of complications among the three groups. No discernible linear relationships between the width of the opening gap and the bone union score were found.ConclusionFor MOWHTOs with an average gap opening width of 12.1 mm, autografts resulted in superior bone union outcomes compared to allografts and no graft at 1 year postoperatively. However, no bone graft achieved similar outcomes to allografts, suggesting that routine use of allografts should not be recommended.

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The results of allogenic cancellous bone graft in medial opening wedge high tibial osteotomy

Yazdi

Haris²,

Rohani³

et al. 2022

Eur J Orthop Surg Traumatol

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Effectiveness of bone substitute materials in opening wedge high tibial osteotomy: a systematic review and meta-analysis

Cited by 17 publications

References 52 publications

Bone Regeneration After Implantation of Calcium Phosphate Cements Based on Metastable Tricalcium Phosphate (In Vivo Experimental Study)

Bone Regeneration After Implantation of Calcium Phosphate Cements Based on Metastable Tricalcium Phosphate (In Vivo Experimental Study)

No Superior Bone Union Outcomes with Allografts Compared to No Grafts and Autografts Following Medial Opening Wedge High Tibial Osteotomy: A Retrospective Cohort Study

The results of allogenic cancellous bone graft in medial opening wedge high tibial osteotomy

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