Flatfoot Clinical Trial
Official title:
Calcaneal Neck Lengthening Osteotomy - Allogen Bone Graft Material Versus a Hydroxyappatite / β- Tricalcium Phosphate Bone Substitute
In this foot deformity (plano valgus) surgery may be indicated. The deformity is corrected with an osteotomy at the heelbone. In most cases bone graft material has to be obtained from the iliac crest to support the osteotomy. In the planned study a group of children will be operated with an artificial bone graft material and thus avoiding the need harvesting of bone graft at the iliac crest.
Planovalgus or flatfoot deformity is observed in children with different neuromuscular
disorders and is associated with pain and gait disorders due to non-reducible talonavicular
joint subluxation. Surgical treatment is aimed at correcting foot malalignement and
achieving sufficient plantar flexion in the ankle joint. With a calcaneal lengthening
osteotomy procedure the planovalgus deformity can be corrected but it requires the use of
graft material to be inserted as a bone wedge at the osteotomy site. In this way the
talonavicular joint is indirectly reduced. Obtaining autograft material from the iliac crest
in growing children carries a risk of growth arrest and iliac wing deformity which has led
to widespread use of allograft bone when performing the operation.
New materials are being developed as substitutes for bone graft material with biphasic
calcium phosphate ceramic (BCP) being the most commonly used. BCP is a mixture of porous
hydroxyapatite (HA) and β-tricalcium phosphate (β -TCP). Calcium phosphate ceramics have
excellent biocompatibility and are thought to be able to facilitate and guide new bone
growth. This has been demonstrated in experimental studies. In retrospective clinical
studies on patients having filled large bone defects with hydroxyapatite graft material
radiological healing is seen at follow ups after average 7.9 years. It has also previously
been demonstrated that BCP can be used as artificial bone graft in osteotomies with a good
result and complete healing of the osteotomi.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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