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Watanabe A, Kikuchi N, Ichihara T, Kumagai H, Taniguchi Y, Sato Y, Kinugasa T, Ikeda K, Yamazaki M. Use of Unidirectional Porous β-Tricalcium Phosphate in the Tibial Tunnel for Anterior Cruciate Ligament Reconstruction: A Case Series. Cureus 2024; 16:e58366. [PMID: 38756267 PMCID: PMC11097233 DOI: 10.7759/cureus.58366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/18/2024] Open
Abstract
Bone defects in the tibial tunnel for anterior cruciate ligament (ACL) reconstruction can cause adverse events. The unidirectional porous tricalcium β-phosphate (UDPTCP) has the potential to be used as a filling substitute for bone defects. In this case series, we present the first nine cases in which UDPTCP was used as a bone substitute in the tibial tunnel during ACL reconstruction. The patients comprised six males and three females, with an average age of 32 years (range: 16-50 years). A cylindrical UDPTCP measuring 10 x 20 mm was molded to fit the tibial tunnel and then implanted. At the one-year postoperative follow-up, none of the patients demonstrated any complications, and bone remodeling was observed on radiographs. Therefore, UDPTCP may provide a safe and reliable filling substitute for the tibial tunnel in ACL reconstruction.
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Affiliation(s)
- Arata Watanabe
- Department of Orthopaedic Surgery, Ichihara Hospital, Tsukuba, JPN
| | - Naoya Kikuchi
- Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, JPN
| | - Takumi Ichihara
- Department of Orthopaedic Surgery, Ichihara Hospital, Tsukuba, JPN
| | - Hiroshi Kumagai
- Department of Orthopaedic Surgery, Ichihara Hospital, Tsukuba, JPN
| | - Yu Taniguchi
- Department of Orthopaedic Surgery, Ichihara Hospital, Tsukuba, JPN
| | - Yuki Sato
- Department of Orthopaedic Surgery, Ichihara Hospital, Tsukuba, JPN
| | | | - Kotaro Ikeda
- Department of Orthopaedic Surgery, Ichihara Hospital, Tsukuba, JPN
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, JPN
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Kikuchi N, Yoshioka T, Okuno K, Kanamori A, Yamazaki M. Characterization of bone remodeling of two different porous types of β-tricalcium phosphates: a quantitative site-by-site analysis using computed tomography. J Artif Organs 2021; 25:254-261. [PMID: 34846598 DOI: 10.1007/s10047-021-01304-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/05/2021] [Indexed: 02/03/2023]
Abstract
This study compared the process of bone remodeling using spherical porous β-tricalcium phosphate (SPTCP) and unidirectional porous β-tricalcium phosphate (UDPTCP) by quantitative computed tomography (CT) analysis. We retrospectively analyzed the data of 16 patients (4 men, 12 women; age, 43-78 years) who underwent medial opening wedge high tibial osteotomy (MOWHTO) and were followed up for 1 year postoperatively. Nine patients used SPTCP spacers and seven patients used UDPTCP spacers. CT was performed at 1 week, 6 months, and 1 year postoperatively. CT attenuation values were measured at three sites on the axial slice and sagittal slice, i.e., the superior, center, and inferior sites and the lateral, center, and medial sites for UDPTCP and SPTCP, respectively. CT attenuation values were lower for UDPTCP than for SPTCP in all sites at 6 months and 1 year postoperatively (p < 0.05). CT attenuation values decreased in the superior and inferior sites for UDPTCP (p < 0.05), and CT attenuation values decreased in the lateral site for both SPTCP and UDPTCP (p < 0.05). The process of bone remodeling differed between the two over a short-term follow-up of 1 year postoperatively.
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Affiliation(s)
- Naoya Kikuchi
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Tomokazu Yoshioka
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. .,Division of Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Kosuke Okuno
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Akihiro Kanamori
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masashi Yamazaki
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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Unidirectional porous beta-tricalcium phosphate and hydroxyapatite artificial bone: a review of experimental evaluations and clinical applications. J Artif Organs 2021; 24:103-110. [PMID: 33893573 PMCID: PMC8154753 DOI: 10.1007/s10047-021-01270-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/12/2021] [Indexed: 11/27/2022]
Abstract
In Japan, where allograft bone transplantation is not widespread, prospects for artificial bones are very high. Therefore, artificial bones with various compositions, porous structures, and porosities have been developed and employed for clinical use. Both Affinos® and Regenos® (made of beta-tricalcium phosphate and hydroxyapatite, respectively) are artificial bones with a unique unidirectional porous structure, in which pores with a diameter suitable for tissue penetration (25–300 μm) are aligned in one direction. The unidirectional porous structure allows rapid penetration of blood deep into the materials by a capillary effect. In animal experiments, Affinos® showed well-balanced resorption and was replaced with the host’s own bone from an early stage after implantation and new bone formation and remodeling were observed in the cortical bone and medullary cavity. When implanted for clinical situation, resorption from an early stage and good replacement with the patient’s own bone were also observed. Regenos® has an internal osteon-like material and a vascular-like structure that is maintained within the pores even after long-term implantation, as noted in an animal experiment. When implanted for clinical situation, good osteoconductivity was observed from an early stage of implantation. In addition, the material was observed to be slowly absorbed over time in some cases. We have discussed the beneficial effects of combining teriparatide and platelet-rich plasma impregnation and the potential prospects of these artificial bones.
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