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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2013 June;64(3):305-17
language: English, Italian
Incorporation of bone substitute utilized in open wedge high tibial osteotomy: MRI analysis
Asteggiano E. 1, Atzori F. 1, Busso M. 2, Arrigoni C. 1, Crosio A. 1, Massè A. 1 ✉
1 Unit of Orthopedics and Traumatology, San Luigi Gonzaga University Hospital Orbassano, Turin, Italy;
2 Unit of Radiodiagnostic, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
Aim: the proposed study utilized the magnetic resonance imaging (MRI) technique to analyse osteointegration and rehabitation of substitute bone following the positioning of a tricalcium phosphate (TCP) wedge in opening wedge high tibial osteotomy, procedure clinically validated for the correction of varus knee. Studies available to evaluate the quality of the new tissue inside the osteotomy are rare and utilise only standard radiography.
Methods: Ten patients who underwent the procedure (4 bilaterally) between 2008 and 2012 have been recruited. A MRI exam has been performed on each of them, in a temporary interval between 15 days and 3 years from the procedure. The clinical outcome has been evaluated by the Tegner Lysholm Knee Scoring Scale, both preoperatively and at least 6 months from the operation.
Results: Clinical results show a progressive improvement of the pain and the quality of life. Imaging results show a different signal intensity of the bone substitute from the surrounding tissues, constant in time. With the progressive increase of the temporal distance between the procedure and the MRI exam, it is evident the formation of a sclerotic line delimiting the wedge.
Conclusions: Thanks to our results, we can confirm the clinical efficacy of this surgical intervention for the correction of the varus knee. The MRI imaging shows that the osteointegration process, assumed as the formation of the sclerotical line around the wedge, has been occurred; the rehabitation process hasn’t took place, because of the absent change of the MRI signal of the substitute bone inserted.