Opening wedge high tibial osteotomy using 3D biomodelling Bonelike® macroporous structures: case report
Two synthetic calcium phosphates in porous wedge shape, Bonelike® and a commercial HA/β-TCP biphasic material, were used as an alternative to bone autografts and allografts in the treatment of medial compartment osteoarthritis of varus knees. The structure of Bonelike® has a 3D architecture that is computer controlled, and a composition that mimics the mineral composition of natural bone. The HA/β-TCP biphasic material used as a control material in this study was prepared using conventional foaming based methods. No signs of inflammatory reactions were observed post-operatively for both materials. After 4 months signs of fusion at the osteotomy site and good integration of the implanted wedges were observed, showing good mechanical resistance. Concerning the final correction attained, the left knee revealed a satisfactory valgus of 10°, but the right one only had a final value of 6°. The clinical evaluation using International Knee Score (IKS) showed good outcome in all parameters with complete range of motion in both knees and climbing stairs without crutches with only slight pain.
KeywordsHigh Tibial Osteotomy Bone Ingrowth Osteotomy Site Tricalcium Phosphate Open Wedge High Tibial Osteotomy
The authors express their grateful thanks to the FCT – Fundação para a Ciência e a Tecnologia for their support in this work through the project “New generation of bioactive and bioresorbable materials for bone regenerative surgery using 3D biomodelling” POCTI/CTM/59091/2004 and also through Post-Doctoral grants SFRH/BPD/14969/2004 and SFRH/BPD/6010/2001.
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