Bone remodeling dynamics in patients with achondroplasia after lengthening the lower limbs according to MSCT data

Дьячков К.А., Дьячкова Г.В., Аранович А.М., Климов О.В.

Abstract


Purpose. To study the dynamics of remodeling the tibiae in patients with achondroplasia (AChP) after their lengthening.
Material and Methods. Remodeling of tibiae after their lengthening studied using the method of polypositional roentgenography, that of computed tomography (CT) and multisectional computed tomography (MSCT) in 47 patients with achondroplasia at the age of 14-20 years.
Results. As our data demonstrated, remodeling of distraction regenerated bone is similar to the process of bone natural growth. When newly-formed bone load increased with appropriate biomechanical and biochemical changes the trabecular adaptation of bone tissue occurred, the inter-trabecular space filled with bone thereby forming a cortical plate with simultaneous resorption of trabeculae in the area of future medullary canal.
Conclusion. Bone remodeling in the zone of distraction regenerated bone takes place by several stages, and consists in forming longitudinally oriented bone trabeculae with further trabecular resorption in the medullary canal up to complete organotypic reorganization which ends in 1-1.5 year. The algorithm of bone quality studying should include advanced techniques of MSCT data processing. The process of studying the cortical plate quality should be accompanied by measuring its total and local density.

Keywords


achondroplasia, lengthening, bone remodeling, computed tomography, roentgenography

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