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The Bone & Joint Journal
Vol. 103-B, Issue 3 | Pages 456 - 461
1 Mar 2021
Clinical and radiological assessment of the induced membrane technique using beta-tricalcium phosphate in reconstructive surgery for lower extremity long bone defects
Sasaki G Watanabe Y Yasui Y Nishizawa M Saka N Kawano H Miyamoto W
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Aims

To clarify the effectiveness of the induced membrane technique (IMT) using beta-tricalcium phosphate (β-TCP) for reconstruction of segmental bone defects by evaluating clinical and radiological outcomes, and the effect of defect size and operated site on surgical outcomes.

Methods

A review of the medical records was conducted of consecutive 35 lower limbs (30 males and five females; median age 46 years (interquartile range (IQR) 40 to 61)) treated with IMT using β-TCP between 2014 and 2018. Lower Extremity Functional Score (LEFS) was examined preoperatively and at final follow-up to clarify patient-centered outcomes. Bone healing was assessed radiologically, and time from the second stage to bone healing was also evaluated. Patients were divided into ≥ 50 mm and < 50 mm defect groups and into femoral reconstruction, tibial reconstruction, and ankle arthrodesis groups.

Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_I | Pages 77 - 77
1 Mar 2010
PAPER 40: CLINICIAN’S ABILITY FOR MONITORING MECHANICAL STATUS OF HEALING LENGTHENING CALLUS FROM PLAIN X-RAY PHOTOGRAM
Takenaka N Watanabe Y Nishizawa M Nishizawa Y Matsushita T
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Objective: The purpose of the present study was to assess whether clinicians are actually able to evaluate the mechanical status of lengthening callus from plain radiographs.

Materials and Methods: 36 rats were employed in this study. Their left femurs were lengthened by 6 mm as a bone lengthening model. Rats were euthanized at 4 8 12 and 16 weeks after lengthening. Both femora were X-rayed and then bone density parameters (bone mineral content, bone mineral density and bone area) of lengthening callus were measured using pQCT. Three-point bending test was performed to determine the mechanical strength of the both bones. We defined the ratio of the strength of lengthening side to control side as estimated strength recovery rate (%). Then 20 orthopaedic surgeons evaluated only the X-ray photographs and tried to estimate the relative mechanical strength (%) of the affected side compared to the control side.

Results: Between the recovery percentage of mechanical strength and bone mineral content, a positive simple correlation (R2=0.11, p< 0.05) was seen. No significant correlation was seen between the recovery percentage of mechanical strength estimated by orthopaedists and the mechanical strength measured by three-point bending test (qualified doctors: R2=0.0793 p=0.291 unqualified doctors: R2=0.0523 p=0.394).

Discussion and conclusion: It became obvious that to estimate the strength of lengthening callus from plain radiographs alone is quite difficult as compared with the studies of the simple fracture model that have been reported until now.