背景:髂棘自体移植经常用于填充截骨术后的骨缺损。尽管如此,自体骨移植的手术与供体部位的发病率和疼痛有关。已经探索了替代方法,但是,在几种骨科手术中,没有共识指导其作为常规实践的应用。因此,本研究旨在比较自体与同种异体骨在内侧开口楔形胫骨高位截骨术中的疗效和安全性。
方法:47例有症状的单侧膝内翻并有胫骨高位截骨指征的患者被随机分配接受自体移植或同种异体移植以填充截骨部位。手术时间,骨愈合,和并发症发生率(延迟愈合,骨不连,浅层和深层感染,损失校正,和硬件故障)在一年的随访后记录。数据表示为平均值±标准偏差,并且当p<0.05时认为具有统计学意义。
结果:两组之间的放射学愈合时间相似(同种异体移植物:2.38±0.97个月vs.自体移植:2.45±0.91个月;p=0.79)。两组并发症发生率也相似,同种异体移植组感染1例,自体移植组感染2例,同种异体移植组的两个延迟结合,自体移植组三个。两组手术时间相差11分钟,同种异体移植组较低(同种异体移植:65.4±15.1minvs.自体移植:76.3±15.2分钟;p=0.02)。
结论:Iu骨同种异体移植物可以安全有效地用于内侧开口楔形胫骨高位截骨术,因为它可以促进与自体移植物相同的骨愈合率,具有缩短手术时间的好处。
背景:U1111-1280-0637,2022年12月1日,回顾性注册。
BACKGROUND: Iliac crest
autograft is frequently used to fill in bone defects after osteotomies. Nonetheless, surgery for bone
autograft procurement is associated with morbidity and pain at the donor site. Alternatives to it have been explored, but there is no consensus to guide their application as a routine practice in several orthopedic procedures. Thus, this study was designed to compare the efficacy and safety between iliac crest autograft and allograft in medial opening wedge high tibial osteotomy.
METHODS: Forty-seven patients with a symptomatic unilateral genu varum and an indication for high tibial osteotomy were randomly assigned to receive either autograft or allograft to fill the osteotomy site. Operative time, bone healing, and complication rates (delayed union, nonunion, superficial and deep infection, loss of correction, and hardware failure) were recorded after a one-year follow-up. Data were expressed as Mean ± Standard Deviation and considered statistically significant when p < 0.05.
RESULTS: The time to radiologic union was similar between both groups (Allograft: 2.38 ± 0.97 months vs.
Autograft: 2.45 ± 0.91 months; p = 0.79). Complication rates were also similar in both groups, with one infection in the allograft group and two in the autograft group, two delayed unions in the allograft group, and three in the
autograft group. The operative time differed by 11 min between the groups, being lower in the allograft group (Allograft: 65.4 ± 15.1 min vs.
Autograft: 76.3 ± 15.2 min; p = 0.02).
CONCLUSIONS: Iliac crest allografts can be safely and effectively used in medial opening wedge high tibial osteotomy as it promotes the same rates of bone union as those achieved by autologous grafts, with the benefits of a shorter operative time.
BACKGROUND: U1111-1280-0637 1 December 2022, retrospectively registered.