Does Ossein-Hydroxyapatite Complex Improve the Results of Lower-Leg Lengthening Osteotomies with the Ilizarov Method?

Background: Good Ilizarov treatment outcomes are associated with low complication rates, rapid formation of strong bone regenerate, and relatively early removal of the Ilizarov external fixator. Some authors recommend the use of pharmaceutical agents that facilitate and accelerate bone union. There are no previous studies evaluating Osteogenon in Ilizarov osteotomies. The purpose of our study was to assess radiological and clinical effects of Osteogenon in patients undergoing osteotomy combined with Ilizarov fixation. Methods: In this retrospective study we assessed 35 patients who had undergone lower leg lengthening osteotomies with the Ilizarov method in the years 2021-2022 and received adjunctive Osteogenon. The control group comprised 60 patients matched for age, sex, BMI, and comorbidities, who did not receive Osteogenon. We assessed the following clinical and radiological parameters: the duration of fixation, total initial limb shortening, total limb lengthening, achieving bone union following osteotomy, elongation index, alignment index, complications, analgesic use, and satisfaction with treatment. Results: The median duration of fixation was worse (longer) in the Osteogenon group (183 days) compared to the control group (143 days), p = 0.014. There were no differences between groups in initial limb shortening, median limb lengthening, median elongation index, median alignment index, and complication rate. A proportion of 22.9% of patients in the Osteogenon group and 80% patients in the control group took analgesics on post-treatment follow-up, p < 0.001. In the study, 65.71% of Osteogenon patients and 55% of control patients were very satisfied with the treatment. Conclusions: Taking Osteogenon improves patient's satisfaction with treatment and limits analgesic use following osteotomies combined with Ilizarov fixation. Osteogenon was associated with a significantly longer external fixation period and failed to demonstrate measurable improvements in radiological outcomes. Any considerations regarding the potential benefits of using Osteogenon should be treated with caution.