Abstract
Objective: Hydroxyapatite (HA) and beta-tricalcium phosphate (TCP) have been utilized as calcium phosphate-based bioceramics in various types of orthopedic surgery. Many basic studies have reported that these biomaterials have excellent osteoconductivity and/or absorbability properties under various experimental conditions. The purpose of this study was to clinically and radiologically compare the utility and osteoconductivity of TCP and HA spacers used in medial open-wedge high tibial osteotomy (HTO).
Methods: Thirty patients (31 knees) who underwent medial open-wedge HTO using a locked low-profile plate were followed up. In the first 19 knees, a wedged HA spacer was implanted in the opening space in HTO (Group H). In the remaining 12 knees, a wedged TCP spacer was implanted in the same manner (Group T). The patients underwent both clinical and radiological examinations before surgery and at 1 year after surgery.
Results: There were no statistical differences between the two groups with respect to preoperative background factors and there were no intra- or postoperative complications in either group. Osteoconductivity was assessed using the modified van Hemert's score. In Group T, the score was significantly higher (P=0.009) than that of Group H in the most medial osteotomy zone, while there were no significant differences between the two groups in the other zones. There were no statistical differences between Groups H and T with respect to the postoperative Japan Orthopaedic Society score, the femorotibial angle, the weight-bearing line, the tibial slope, and the Insall-Salvati ratio.
Conclusion: The present study demonstrated that TCP spacers are significantly superior to HA spacers in terms of osteoconductivity at 1 year after medial open-wedge HTO.
