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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2011 August;62(4):239-45
The role of ct and dexa in the evaluation of biomaterial hatric graft osteointegration in high tibial osteotomy
Marenco S. 1, Bellato E. 1, Marini E. 1, Mortera S. 1, Castoldi F. 1, Borré A. 2, Castellano S. 2, La Russa M. 1, Marmotti A. 1, Cottino U. 1
1 Struttura Complessa Dipartimento Universitario di Ortopedia e Traumatologia, Ospedale Mauriziano Umberto I, Torino, Italia;
2 Struttura Complessa di Radiologia, Azienda Ospedaliera CTO Maria Adelaide, Torino, Italia
Aim. Proximal tibial osteotomy, with Puddu’s plate fixation, has become, in Europe, one of the most popular surgical procedures utilized to treat arthrosis of medial compartment in varus knee. A standard X-ray in front-backside and lateral-sideward projections is usually used to evaluate post surgical results. That could be inadequate to evaluate with precision the evolution of osteotomy recovery. That is the reason why it is important to find other techniques of evaluation of bone osteointegration.
Methods. Twenty patients enrolled for the study underwent proximal tibial osteotomy with Puddu’s plate fixation. Two months after surgery patients were evaluated using two alternative techniques to complement conventional radiology: the first technique is CT with 3d evaluation of bone density that enables the acquisition of multiple points measurements, expressed in HU The second one is DEXA expressed in BMD, that permits to obtain useful data of bone quality.
Results. CT measurements: the relationship between the mean HU density measures of proximal bone and the native one are: 1 HU with a SD of 0.47, whereas HU measures in the distal site are: 1.4 HU with a SD of 0.61. DEXA measurements: the relationship between the mean BMD density measures expressed in g/cm of proximal bone and the native one are 0.99 g/cm2 with a SD of 0.36, whereas BMD density measures in the distal site are: 1.1 g/cm with a SD of 0.53.
Conclusions. The results obtained in this study suggest that both TC and DEXA techniques are adequate to evaluate osteointegration of a scaffold, like HatriC at bone interface, without being invasive as biopsy can be.