Artikel
A porcine experimental histomorphometric analysis of the growth plate following temporary hemiepiphysiodesis with tension band plates and staples
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Autoren
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Julia Sattelberger
- Universitätsklinikum Münster, Klinik für Allgemeine Orthopädie und Tumororthopädie, Kinderorthopädie, Deformitätenrekonstruktion u. Fußchirurgie, Münster, Germany
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Hauke Hillebrand
- Universitätsklinikum Münster, Klinik für Allgemeine Orthopädie und Tumororthopädie, Kinderorthopädie, Deformitätenrekonstruktion u. Fußchirurgie, Münster, Germany
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Georg Gosheger
- Universitätsklinikum Münster, Klinik und Poliklinik für Allgemeine und Tumororthopädie, Münster, Germany
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Robert Rödl
- Universitätsklinikum Münster, Klinik für Allgemeine Orthopädie und Tumororthopädie, Kinderorthopädie, Deformitätenrekonstruktion u. Fußchirurgie, Münster, Germany
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Ahmed Abdul-Hussein Abood
- Paediatric Orthopaedic Research Institute, Dept. of Children's Orthopaedics, University Hospital Aarhus, Aarhus, Denmark
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Ole Rahbek
- Paediatric Orthopaedic Research Institute, Dept. of Children's Orthopaedics, University Hospital Aarhus, Aarhus, Denmark
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Bjarne Moeller-Madsen
- Paediatric Orthopaedic Research Institute, Dept. of Children's Orthopaedics, University Hospital Aarhus, Aarhus, Denmark
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Björn Vogt
- Universitätsklinikum Münster, Klinik für Allgemeine Orthopädie und Tumororthopädie, Kinderorthopädie, Deformitätenrekonstruktion u. Fußchirurgie, Münster, Germany
| Veröffentlicht: | 6. November 2018 |
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Gliederung
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Objectives: Tension band devices are considered the gold standard for angular correction by temporary hemiepiphysiodesis. Their flexible biomechanical behaviour is believed to reduce the risk of premature closure of the growth plate compared to traditional rigid and compressive Blount staples. However, in a previous porcine experimental study similar histomorphometric effects of tension band plates (eight-PlatesTM) and rigid Blount staples on the growth plate were found. Both devices elicited growth retardation with narrowing of the growth plate and release of the temporary hemiepiphysiodesis led to enlargement of the growth plate and areas with disorganized cartilage [1]. Recently, flexible staples (FlexTacksTM) were introduced. Those tension band staples have not yet been investigated in experimental trials. Therefore, this histomorphometric study compares the effect on the growth plate following temporary hemiepiphysiodesis with either eight-PlatesTM or FlexTacksTM in a porcine animal model.
Methods: A paired randomized design was used. The right proximal tibia was randomly allocated to medial temporary hemiepiphysiodesis by either eight-PlatesTM or FlexTacksTM. The left side received the opposite treatment. The animals were divided into group A (n=6) and group B (n=6). The implants were removed after nine weeks in both groups. The pigs in group B were housed for additional five weeks (Figure 1 [Fig. 1]). Histological samples were taken from the medial (treated) and lateral (untreated) cartilaginous grwoth plate for analysis using our previously described standardized histological setup (Figure 2 [Fig. 2]). A paired T test was used for statistical analysis.
Results and conclusion: No significant changes were observed between histomorphometric parameters in neither study A or B. In contrast to our previous findings areas with disorganized cartilage were rare regardless of the used device in both study A and B. Chondrocyte zone fractions and height of the growth plate neither differed between the treated and untreated side nor between the implants (Table 1 [Tab. 1], Table 2 [Tab. 2], Table 3 [Tab. 3]).
Tension band devices – both plates and flexible staples – seem to be safe implants for reversible physeal arrest without histomorhometric disturbances of the growth plate architecture or microscopic signs of premature closure of the physis.
References
- 1.
- Gottliebsen M, Rahbek O, Poulsen HD, Møller-Madsen B. Similar growth plate morphology in stapling and tension band plating hemiepiphysiodesis: a porcine experimental histomorphometric study. J Orthop Res. 2013 Apr;31(4):574-9. DOI: 10.1002/jor.22276
