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. 2025 May 12;14(10):3353.
doi: 10.3390/jcm14103353.

The Use of Ossein-Hydroxyapatite Complex in Conjunction with the Ilizarov Method in the Treatment of Tibial Nonunion

Piotr Morasiewicz  1 , Monika Zaborska  2 , Michał Sobczak  2 , Łukasz Tomczyk  3 , Daniele Pili  4 , Krystian Kazubski  1 , Paweł Leyko  1
Affiliations

The Use of Ossein-Hydroxyapatite Complex in Conjunction with the Ilizarov Method in the Treatment of Tibial Nonunion

Piotr Morasiewicz et al. J Clin Med. .

Abstract

Background: Patients with nonunion experience pain, mobility problems, and physical activity limitations; require long-term, costly treatment; and cannot resume work. Some authors recommend the use of pharmaceutical agents as an adjunct therapy in fracture and nonunion treatment. The aim of this study was to assess the effects of ossein-hydroxyapatite complex used as an adjunct therapy in nonunion treatment with the Ilizarov external fixator. Methods: In this retrospective study, we assessed 31 patients (nine women, 22 men) at a mean age of 47 years (29-68 years), who were receiving osteogenon, with aseptic tibial shaft nonunion treated with the Ilizarov external fixator in the period 2019-2023, designated as Group 1. The control group comprised 29 patients (five women, 24 men), at a mean age of 48 years, with aseptic tibial shaft nonunion treated with the Ilizarov external fixator, who did not receive osteogenon during treatment, designated as Group 2. We assessed the following parameters-duration of Ilizarov fixation, achieved bone union, time to resuming normal physical activity, maintained bone union, time to complete pain relief, the number of patients reporting complete pain relief, the number of patients who were fitted with a cast or splint following Ilizarov fixator removal, and the rate of complications. Results: The median time to Ilizarov fixator removal was 275 days in Group 1 and 218 days in Group 2. In Group 1, bone union was observed in 100% of patients, in Group 2, 93% of patients achieved bone union. This difference was statistically significant, p = 0.041. Maintained bone union was observed in 85.7% of patients from the osteogenon group and in 79.3% of patients from the control group, and the difference was not statistically significant. There were no differences between groups in the median time to resuming normal physical activity, the median time to achieving pain relief, the rate of complications, and the rate of pain relief. Conclusions: The use of ossein-hydroxyapatite complex has a beneficial effect on fracture nonunion treatment with the Ilizarov method. The use of osteogenon helps increase the proportion of patients with fracture nonunion who achieve bone union following treatment with the Ilizarov method. Osteogenon does not significantly affect complication rates, time to fixator removal, time to achieving pain relief, time to resuming normal physical activity, maintained bone union rates, or the proportion of patients who achieve pain relief.

Keywords: Ilizarov method; bone nonunion; ossein–hydroxyapatite complex; osteogenon; tibial nonunion.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
(A) patient before surgery, (B) patient during treatment with the Ilizarov method, (C) long-term result.
Figure 2
Figure 2
Duration of Ilizarov stabilization in the osteogenon group and control group.
Figure 3
Figure 3
Percentage of bone union in the osteogenon group and control group.
See this image and copyright information in PMC

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