Comparison Between a Novel Bovine Xenoimplant and Autogenous Cancellous Bone Graft in Tibial Tuberosity Advancement

Abstract

Radiographic evidence of healing of the xenoimplanted portion of the TTA osteotomy was equivalent to results with ACBG. Healing of the proximal osteotomy site (above the cage) was improved when ACBG was used as the graft.

Comparison of Healing of the Osteotomy Gap after Tibial Tuberosity Advancement with and without Use of an Autogenous Cancellous Bone Graft

“…Using commercially available allograft, 10,19 or another bone substitute 13,14 are reported options to avoid harvesting autograft, but these options increase the surgical costs, making them unattractive in many countries, and apparently are not necessary.…”

“…As initially recommended, the opening wedge was filled with autogenous cancellous bone graft taken from the tibial metaphysis, caudal to the osteotomy 2,7,8,11,12 . Other reported options are to harvest the graft from the distal aspect of the femur 9,10 ; to use allograft 10 ; xenograft 13 ; to position a block of tricalcium phospate 2 ; or to fill the defect with nanohydroxyapatite 14 . We are unaware of studies prospectively evaluating healing of the gap created by TTA.…”

“…Nanohydroxyapatite paste (Ostium ® ; Heraeus Kulzer Inc., Armonk, NY) increase costs ∼US$100/dog 19 . Healing seems to occur regardless of the grafting material used 7–10,13,14 and use of bone graft to stimulate healing of the TTA gap may not be needed based on previous clinical reports 2,14 . Eliminating this additional surgical procedure may decrease the cost and morbidity of TTA.…”

A modified Maquet technique for management of cranial cruciate avulsion in a cat

“…There is controversy over the need to use bone graft in TTA (Boudrieau 2011, Bisgard et al 2011, Guerrero et al 2011, Kuipers von Lande et al 2012. The decision to use DBM was influenced by the low volume of cancellous bone available from the proximal tibia, difficulty accessing this because of the MMT procedure being performed, and the morbidity encountered during collection of autogenous bone graft from other sites such as the lateral femoral condyle or ilium.…”

Comparação das técnicas de osteotomia para avanço da tuberosidade tibial (TTA) e nivelamento do platô tibial (TPLO) para correção de ruptura do ligamento cruzado cranial em cães com o sistema de baropodometria

“…(JOHNSON, 1986;YOUNGER;CHAPMAN, 1989;FITCH et al, 1997). Porém, esta manobra é indicada para promover o preenchimento da falha em menor tempo (FITCH et al, 1997;WALTER, 1999;DOREAL et al, 2005;OWEN, 2008;KUIPERS et al, 2012), uma vez que este material apresenta propriedades osteocondutoras, osteogênicas e osteoindutoras (JOHNSON; BELLENGER, 1980 Osteoartrose secundária é uma das consequências da RLCCr LAZAR et al, 2005;HOFFMANN et al, 2006;DE BRUIN et al, 2007a) e esta foi visualizada em diferentes níveis de gravidade em praticamente todos os pacientes avaliados nos dois grupos desta tese. A gravidade da OA no joelho não está diretamente relacionada com claudicação em cães WILKE et al, 2005), sendo observado nos animais desta tese que, mesmo tendo todos os animais do grupo TPLO e 90% dos cães do grupo TTA, apresentado algum grau de OA no momento da cirurgia, esta não impediu melhora do apoio dos animais nos dois grupos.…”