Long-term changes in bone and cartilage after Ravitch's thoracoplasty: findings from multislice computed tomography with 3-dimensional reconstruction.

BACKGROUND/PURPOSE: The aim of the study was to evaluate the long-term changes in the bones, cartilage, and chest wall contour after a Ravitch's thoracoplasty (RTP) using multislice computed tomography with 3-dimensional reconstruction (3D-MSCT).

METHODS

Between 1985 and 2000, 114 patients with pectus excavatum (PE) underwent RTP in our hospital; 3D-MSCT was performed in 36 patients 4 to 18 years after the initial operation. Twenty-four patients with PE with no surgical intervention were enrolled as a control group.

RESULTS

Partial or complete calcification of the regenerated cartilage was found in 23 (64%) of the patients. Threadlike regenerated cartilage or the complete absence of some segment was seen in 14 cases (39%). Clubbing of the bony end was found in 23 cases (64%). Shortening of the gap between the rib end and the sternum (n = 17, 47%) and "constrict-in" of the ribs (n = 13, 36%) were common after RTP. In the control group, no significant bone or cartilage change occurred compared to the RTP group.

CONCLUSIONS

Modern 3D-MSCT technology can clearly depict the cartilage and bone in patients with PE. More than 60% of the patients with PE showed significant long-term changes in the bone and cartilage after RTP. Further studies are warranted to evaluate the impact of these abnormal findings.