In Vivo Histological Examination of the Graft Site 3 Years After Open-wedge High Tibial Osteotomy with Nanohydroxyapatite Augmentation

Overview

Journal J Orthop Case Rep

Specialty Orthopedics

Date 2022 Apr 13

PMID 35415095

Authors

Giorgio Princi

Marco Rossini

Fabio Marzilli

Riccardo Di Niccolo

Fabio Conteduca

Andrea Ferretti

Affiliations

Soon will be listed here.

Abstract

Introduction: The open-wedge high tibial osteotomy (OWHTO) is a common technique for the treatment of medial compartmental osteoarthritis of the knee. There are many options to fill the osteotomy site gap. The autologous graft donor site morbidity can be avoided using heterologous bone grafts which represent a valid alternative.

Case Presentation: This case report is about a 52-year-old male with knee osteoarthritis and varus deformity. Due to stiffness, swelling, and painful limitation during daily life activities, the patient underwent OWHTO. The osteotomy gap was filled with an equine cancellous bone wedge and nanohydroxyapatite (NHA) bone paste augmentation. After 3 years, the OWTHO was converted to total knee arthroplasty and a bone biopsy of the previous graft site was performed. The histological examination presented non-viable bone areas surrounded by viable bone without inflammatory cells, suggesting the presence of residual non-viable bone from the bone substitute graft.

Conclusion: The in vivo histology of the graft site after 3 years has shown that heterologous bone is a safe and valid choice as a scaffold for bone regeneration. Augmentation with NHA bone paste achieved good osteoinduction without an inflammatory reaction and good integration of the bone substitute insert.

Citing Articles

Long-Term Structural Changes in the Osteochondral Unit in Patients with Osteoarthritis Undergoing Corrective Osteotomy with Platelet-Rich Plasma or Stromal Vascular Fraction Post-Treatment.

Prizov A, Tchetina E, Volkov A, Eremin I, Zagorodniy N, Lazko F Biomedicines. 2024; 12(5).

PMID: 38791006 PMC: 11118028. DOI: 10.3390/biomedicines12051044.

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