[Xenograft-related complications after filling valgus open wedge tibial osteotomy defects]. / Complications en rapport avec l'utilisation d'une xénogreffe (Lubboc) pour le comblement de l'ouverture médiale dans l'ostéotomie tibiale de valgisation.

PURPOSE OF THE STUDY: The purpose of this study was to assess clinical tolerance and radiological and histological changes observed after using a safe bovine xenograft (Lubboc) to fill open wedge defects after tibial osteotomy for valgisation in patients with medial femoro-tibial degeneration. MATERIAL AND METHODS: Thirty-one valgus open wedge tibial osteotomies were filled with a xenograft (Lubboc) and fixed with an epiphyseal plate in 16 women and 13 men, mean age 55 years two months. All patients had medial femorotibial degeneration with genu varum. Mean varus deviation was 6 degrees. RESULTS: At two years six months follow-up, five patients had developed a local complication: three cases of non-infected discharge and two infections. Among the other 26 cases, the radiographic evolution of the xenograft was similar to that described for autologous grafts but for seven cases, a lucent line persisted, isolating the graft. A biopsy was obtained in fifteen patients during the material removal procedure. Cell infiltration was absent in nine grafts. DISCUSSION: In light of the large number of local complications and the unpredictable nature of the radiological and histological outcome xenografting should be discontinued.

Intraosseous xanthoma without lipid disorders. Case-report and literature review.

A case of intraosseous xanthoma in a patient with a normal lipid profile is reported. Hyperlipidemia is present in most patients with xanthomas. Intraosseous xanthomas are rare, particularly in normolipidemic patients, in whom the presenting symptom is pain without skin lesions. A lytic lesion with a rim of sclerosis is seen on radiographs. Histology shows foam cells, giant cells, and fibrosis. Intraosseous xanthoma is a benign tumor, and other diagnoses must be ruled out (histiocytosis X, Erdheim Chester disease, clear cell carcinoma metastasis). Surgical excision of the lesion is the elective treatment.