DOS 2017

102

· DOS Abstracts

Structural hydroxyapatite tricalciumphosphate graft

vs. tricortical iliac crest autograft in paediatric calca-

neal lengthening osteotomies.

The final results from a randomised controlled noninferiority trial.

Polina Martinkevich, Ole Rahbek, Maiken Stilling, Line Kjeldgaard Pedersen, Mar-

tin Gottliebsen , Kjeld Søballe, Bjarne Møller-Madsen

Children’s Orthopaedics, Aarhus University Hospital

Background:

What if we could avoid donor site pain from harvest of iliac crest

bone graft by using hydroxyapatitetricalciumphosphate (HATCP) as a structural

bone graft for calcaneal lengthening osteotomies (CLO) in children?

Purpose / Aim of Study:

To compare the structural durability of HATCP to au-

tologous iliac crest bone graft in CLO for symptomatic flexible pes planovalgus

(FPPV) by using radiostereometric analysis (RSA).

Materials and Methods:

A randomised controlled two-group parallel non- in-

feriority design with equal randomisation ratio of 1:1 with one year follow-up.

Patients symptomatic PPV aged between 5-16 years were included. The pri-

mary outcome measure was the stability of the osteotomy, assessed by RSA.

Measurements were obtained on the 1st/2nd postoperative day, at 6 weeks, 8

weeks, 6 months and at one year follow-up. Secondary, the health related qual-

ity of life was assessed by the Oxford Ankle Foot Questionnaire, before surgery,

at 6 months and one year follow-up. Other outcome measures were the post-

operative pain, analgesics consumption and complications. Statistics: We would

accept the HATCP group to loose no more than a mean of 2 mm lengthening of

the osteotomy in comparison to the AUTO group at one-year follow-up.

Findings / Results:

There were 7 patients in the HATCP group and 5 in the

AUTO group. One patient was excluded after 8 weeks, due to revisional sur-

gery The difference in graft compression between the two groups (HATCP graft

compression minus AUTO graft compression) was 2.02 mm (two-sided 90%

CI: 0.73; 3.29). Both groups showed similar improvement of the OxAFQ scores

at final follow-up. Complications were more frequently observed in the HATCP

group,

Conclusions:

We find HATCP to be of limited value as a structural bone graft for

calcaneal lengthening osteotomies in its current form.

No conflicts of interest reported

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