Hanke, Alexander and Baeumlein, Martin and Lang, Siegmund and Gueorguiev, Boyko and Nerlich, Michael and Perren, Thomas and Rillmann, Paavo and Ryf, Christian and Miclau, Theodore and Loibl, Markus (2017) Long-term radiographic appearance of calcium-phosphate synthetic bone grafts after surgical treatment of tibial plateau fractures. INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 48 (12). pp. 2807-2813. ISSN 0020-1383, 1879-0267
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Objectives: Synthetic bone grafts (SBGs) are widely used to fill bone defects after fracture reduction. This study assessed the long-term resorption of two different calcium phosphate products (A = ChronOS (TM) inject and B = Norian (R) SRS (R); both DePuy Synthes, Oberdorf, Switzerland) used in the surgical treatment of tibial plateau fractures. Design: Long-term clinical and radiologic follow-up of 52 patients after surgical treatment of intraarticular tibial plateau fractures augmented with SBGs. Setting: The study was performed at a level 3 trauma center. Patients: Between January 2000 and December 2006 a total of 52 patients with intraarticular tibial plateau fractures were operatively treated and augmented with SBGs consisting of a Brushite matix with beta-TCP granules (SBG A) or hydroxylapatite with 4-6% carbonate content (SBG B). 46 patients could be contacted and 38 were included in the study. Half of the patients received SBG A and the other half SBG B. Main outcome measurements: Loss of reduction and SBG resorption was investigated by comparison of follow-up X-ray images to pre-and postoperative X-ray images. Furthermore, pain, activity level and knee function were evaluated by means of questionnaires and clinical examination. Results: The mean age of patients was 59.7 +/- 12.5 years. The follow-up was 8.6 +/- 0.9 years for SBG A and 11.6 +/- 1.4 years for SBG B (p < 0.001). In most cases SBG A was completely resorbed in a homogenous pattern, while SBG B was still visible on the X-ray images revealing a peripheral resorption pattern. A loss of reduction (>2 mm) could be observed in two patients with SBG A and two patients with SBG B, although only one of them had an impaired knee function. Conclusions: The composite SBG A reveals a comprehensive long-term resorption in comparison to SBG B. Nevertheless, both provided suitable mechanical support as part of the surgical treatment of tibial plateau fractures. Level of evidence: Case series, Level IV. (c) 2017 Elsevier Ltd. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | INTERNAL-FIXATION; SUBSTITUTES; CEMENT; SURGERY; SHEEP; Tibial plateau fracture; Synthetic bone graft; Calcium phosphate; Hydroxylapatite; Brushite; beta-TCP; Resorption; Norian SRS; ChronOS inject; Tegner activity scale; Lysholm score; HSS knee score; X-ray; Knee joint; Joint function; Long-term follow-up; Rehabilitation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:19 |
| Last Modified: | 15 Feb 2019 08:47 |
| URI: | https://pred.uni-regensburg.de/id/eprint/1756 |
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