Advantages of creation of holes and removal of air in artificial bone for early bone formation when used artificial bone as a gap filler in open wedge high tibial osteotomy.
Advantages of creation of holes and removal of air in artificial bone for early bone formation when used artificial bone as a gap filler in open wedge high tibial osteotomy.
复制标题
当在开放楔形高位胫骨截骨术中使用人造骨作为间隙填充物时，在人造骨中形成孔并去除空气以促进早期骨形成的优点。
DOI：
10.1007/s00590-018-2286-8
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Tanaka Y.
中科院分区：
文献类型：
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作者：
Tohma Y;Takeuchi R;Tanaka Y.
最近，许多机构使用人工骨作为间隙填充物进行开放楔形高位胫骨截骨术（OWHTO）。然而，在许多情况下，人工骨的使用没有明确的目的。我们推荐一种外科技术来促进人工骨和受体骨之间的早期结合，特别是在OWHTO后的早期。在我们医院，60%孔隙度的β-磷酸三钙（β-TCP）用于OWHTO。最初，将楔形块型β-TCP尽可能大地插入间隙中。然而，从最初的机械支持的角度来看，我们改变了人工骨的尺寸并创造了有意的孔。此外，我们还去除了β-TCP中的气泡。我们根据临床结果和诊断影像来评估结膜紧闭。由于制造孔洞和从人工骨中除去空气，我们注意到，特别是在早期阶段，有一种更快的融合趋势。没有发生胫骨平台骨折、外侧皮质骨折、钢板螺钉失效和矫正损失等不良事件，但人工骨与皮质骨接触放置和与受体骨组织表面接触安装是重要的。在OWHTO中使用人工骨时，建议在手术后早期形成孔洞并从人工骨中取出空气，以便人工骨与受体骨之间更快地融合。应使用人工骨，注意其定位和形状，以获得有效的机械支撑。
Recently, many facilities perform open wedge high tibial osteotomy (OWHTO) using artificial bone as a gap filler. However, there are many cases in which artificial bone is used without a clear purpose. We recommend a surgical technique to promote early synostosis between artificial bone and recipient bone due to mechanical support especially in the early stage after OWHTO. At our hospital, beta-tricalcium phosphate (β-TCP) with 60% porosity is used in OWHTO. Initially, a wedge-shaped block-type β-TCP, as large as possible, was inserted into the gap. However, from the standpoint of initial mechanical support, we changed the artificial bone size and created intentional holes. Furthermore, we removed air bubbles from β-TCP. We evaluated the synostosis on the basis of clinical results and diagnostic imaging. As a result of creating holes and removing air from the artificial bone, a trend toward faster synostosis was noted, especially at the early stage. No adverse events such as tibial plateau fracture, lateral cortical fracture, plate and screw failure and correction loss due to reducing the size of the artificial bone occurred, but placement of the artificial bone in contact with cortical bone and surface contact installation with the recipient bone tissue was important. When using artificial bone in OWHTO, holes formation and removal of air from the artificial bone are recommended for faster synostosis between artificial bone and recipient bone in the early stage after surgery. Artificial bone should be used, with attention to its positioning and shape, for efficient mechanical support.