Alexander Hanke1, Martin Bäumlein2, Siegmund Lang3, Boyko Gueorguiev4, Michael Nerlich3, Thomas Perren5, Paavo Rillmann5, Christian Ryf5, Theodore Miclau6, Markus Loibl7. 1. Department of Orthopaedic Trauma Surgery, Spital Davos, Davos, Switzerland; Department of Trauma Surgery, Regensburg University Medical Center, Regensburg, Germany. 2. Department of Orthopaedic Trauma Surgery, Spital Davos, Davos, Switzerland; Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany. 3. Department of Trauma Surgery, Regensburg University Medical Center, Regensburg, Germany. 4. AO Research Institute Davos, Davos, Switzerland. 5. Department of Orthopaedic Trauma Surgery, Spital Davos, Davos, Switzerland. 6. Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, University of California, San Francisco, CA, United States. 7. Department of Orthopaedic Trauma Surgery, Spital Davos, Davos, Switzerland; Department of Trauma Surgery, Regensburg University Medical Center, Regensburg, Germany. Electronic address: markus.loibl@gmail.com.
Abstract
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™ inject and B=Norian® SRS®; 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 β-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±12.5years. The follow-up was 8.6±0.9years for SBG A and 11.6±1.4years 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 (>2mm) 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.
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™ inject and B=Norian® SRS®; 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 Brushitematix with β-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±12.5years. The follow-up was 8.6±0.9years for SBG A and 11.6±1.4years 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 (>2mm) 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.
Authors: Mersedeh Tohidnezhad; Yusuke Kubo; Philipp Lichte; Tobias Heigl; Diana Roch; Nazanin Barahmand Pour; Christian Bergmann; Tolga Taha Sönmez; Jennifer Vanessa Phi Hock; Athanassios Fragoulis; Felix Gremse; Stefanie Rosenhain; Alexander Slowik; Michaela Bienert; Nisreen Kweider; Christoph Jan Wruck; Holger Jahr; Frank Hildebrand; Hans Christoph Pape; Sabine Neuß; Horst Fischer; Thomas Pufe Journal: Int J Mol Sci Date: 2020-05-01 Impact factor: 5.923