Bioceramic Bone Graft Substitute for Treatment of Unicameral Bone Cysts

Fillingham, Yale A.; Cvetanovich, Gregory L.; Haughom, Bryan D.; Erickson, Brandon J.; Gitelis, Steven

doi:10.1177/1602400220

Cited by 8 publications

(8 citation statements)

References 35 publications

(55 reference statements)

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“…Furthermore, due to the introduction of CP, the mechanical strength of the composite is superior to CS and autogenous cancellous bone (17). Both animal studies and clinical studies have demonstrated the satisfactory osteogenesis and antibiotic loading effect of CS/CP composites (18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

“…The value in our approach of combining vancomycinloaded CS/CP with autologous cancellous bone in induced membrane technology is that it overcomes limited sources of autogenous cancellous bone, thus enabling local antibiotic delivery and enhancing mechanical strength. Although CS/CP has been applied in various clinical fields like the treatment of necrosis of the femoral head, bone cysts, and bone tumors, no studies have analyzed the clinical effect of the induced membrane technique associated with CS/CP as an autologous bone graft expander in the treatment of large infected bone defects (18,19,21).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Induced membrane technique combined with antibiotic-loaded calcium sulfate–calcium phosphate composite as bone graft expander for the treatment of large infected bone defects: preliminary results of 12 cases

Zhi¹,

Wang²,

Zhang³

et al. 2020

Ann Transl Med

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Background: Management of large infected bone defects is a major clinical and socioeconomic problem.The induced membrane technique has been widely used as a solution. However, it has apparent disadvantages such as limited autologous bone graft supply and lack of continuous infection control. Meanwhile, calcium sulfate/calcium phosphate composites have efficacious osteogenesis and antibiotic delivery capacity. For the first time, we analyzed the efficiency of calcium sulfate/calcium phosphate composites as a bone graft expander in the induced membrane technique to treat large infected bone defects. Methods:We retrospectively analyzed the clinical data of 12 patients with large infected bone defects of 6.1-17.2 cm treated with the induced membrane technique from November 2016 to July 2019. In the second reconstruction stage, the bone defect was filled with a mixture of the autogenous iliac bone and vancomycinimpregnated calcium sulfate/calcium phosphate composites at a ratio of 3:1. We assessed the bony union by Samantha X-ray score and recorded infection recurrence and complications. Paley scale and SF-36 score were used to evaluate the function of adjacent joint and quality of life pre and postoperatively. Pearson's correlation coefficients were calculated for union time and other clinical scores.Results: The mean follow-up was 69 weeks (ranging from 30 to 142) after the second stage of the operation. The mean Samantha X-ray score was 5.1 [3-6], preoperative and postoperative SF-36 scores showed that there were statistical differences in all the nine aspects, and the excellent rate of adjacent joint function was 75% (Paley). All cases were radiologically healed, and none of the 12 patients had infection recurrence or failure of fixation at the last follow-up. Two cases had delayed wound healing and were cured after dress changing. There was a significant correlation between union time and Samantha X-ray score (r =-0.887; P=0.000), while there was no correlation between filling dose, size of the defect, and other outcomes.Conclusions: This study provided evidence supporting calcium sulfate/calcium phosphate composites as an effective and safe bone graft expander in the induced membrane technique to treat large infected bone defect. This technique may help decrease the use of autologous bone graft and enhance the anti-infection effect of the induced membrane technique.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Induced membrane technique combined with antibiotic-loaded calcium sulfate–calcium phosphate composite as bone graft expander for the treatment of large infected bone defects: preliminary results of 12 cases

Zhi¹,

Wang²,

Zhang³

et al. 2020

Ann Transl Med

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“…Furthermore, the results of using autologous grafting in simple bone cysts are still poor, possibly due to excessive resorption [2,5,9,20,27]. Calcium sulphate (CaSO 4 ) and calcium phosphate (CaPO 4 ) are osteoconductive, biodegradable, and percutaneously injectable, particularly in the paediatric population [28]. Tey exhibit diferent resorption, mechanical, and side efect profles; calcium sulphate is more acidic and dissolves quicker, resulting in a higher frequency of long-term drainage and subsequent wound complications, whilst calcium phosphate maintains its architecture for a longer duration but has been associated with adverse and sometimes painful soft tissue reactions [29][30][31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

“…Tey exhibit diferent resorption, mechanical, and side efect profles; calcium sulphate is more acidic and dissolves quicker, resulting in a higher frequency of long-term drainage and subsequent wound complications, whilst calcium phosphate maintains its architecture for a longer duration but has been associated with adverse and sometimes painful soft tissue reactions [29][30][31][32][33][34]. Composites have been developed to improve compressive strength and generate intermediate resorption [10,28].…”

Section: Discussionmentioning

confidence: 99%

Injection of a Bone Substitute in the Treatment of Unicameral Bone Cysts

Sivakumar

Dobbe

et al. 2023

Advances in Orthopedics

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Background. Simple bone cysts are benign bony lesions. Treatment strategies are varied for this particular pathology. It remains controversial as to what the ideal treatment strategy is. Recently, bony substitute injections have emerged as a potential option for treatment. This paper aimed to describe our institution’s experience in using bony substitute injections to treat unicameral bone cysts. Methods. A retrospective review of consecutive patients over an 84-month period at a tertiary paediatric hospital was performed. Information regarding patients’ presentation, diagnosis, and management was recorded and summarised. Results. A total of 15 patients were included in our study, with a mean follow-up of 118 weeks. 86.7% of patients demonstrated clinical resolution (absence of pain at the latest follow-up) and 80% of patients demonstrated radiographic resolution. Only one patient sustained a subtrochanteric fracture post-index operation, whilst two others demonstrated redevelopment of cystic architecture on follow-up. Conclusion. This study demonstrates that bone substitute injection is potentially a minimally invasive and seemingly successful technique in the treatment of unicameral bone cysts and other simple bone lesions. Further randomised and comparative studies are required to confirm and validate our findings.

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“…The CaP materials are used to treat bone cysts [ 8 ] caused by an oncotomy in particular. The key problem is to overcome the minimal residual disease and to kill malignant mesenchymal or leukemic cells in the highly vascularized bone and red marrow (RM) areas [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Calcium Phosphate Coating Prepared by Microarc Oxidation Affects hTERT Expression, Molecular Presentation, and Cytokine Secretion in Tumor-Derived Jurkat T Cells

et al. 2020

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Calcium phosphate (CaP) materials are among the best bone graft substitutes, but their use in the repair of damaged bone in tumor patients is still unclear. The human Jurkat T lymphoblast leukemia-derived cell line (Jurkat T cells) was exposed in vitro to a titanium (Ti) substrate (10 × 10 × 1 mm3) with a bilateral rough (average roughness index (Ra) = 2–5 μm) CaP coating applied via the microarc oxidation (MAO) technique, and the morphofunctional response of the cells was studied. Scanning electron microscopy (SEM), X-ray diffraction (XRD), and energy dispersive X-ray spectroscope (EDX) analyses showed voltage-dependent (150–300 V) growth of structural (Ra index, mass, and thickness) and morphological surface and volume elements, a low Ca/PaT ratio (0.3–0.6), and the appearance of crystalline phases of CaHPO4 (monetite) and β-Ca2P2O7 (calcium pyrophosphate). Cell and molecular reactions in 2-day and 14-day cultures differed strongly and correlated with the Ra values. There was significant upregulation of hTERT expression (1.7-fold), IL-17 secretion, the presentation of the activation antigens CD25 (by 2.7%) and CD95 (by 5.15%) on CD4+ cells, and 1.5–2-fold increased cell apoptosis and necrosis after two days of culture. Hyperactivation-dependent death of CD4+ cells triggered by the surface roughness of the CaP coating was proposed. Conversely, a 3.2-fold downregulation in hTERT expression increased the percentages of CD4+ cells and their CD95+ subset (by 15.5% and 22.9%, respectively) and inhibited the secretion of 17 of 27 test cytokines/chemokines without a reduction in Jurkat T cell survival after 14 days of coculture. Thereafter, cell hypoergy and the selection of an hTERT-independent viable CD4+ subset of tumor cells were proposed. The possible role of negative zeta potentials and Ca2+ as effectors of CaP roughness was discussed. The continuous (2–14 days) 1.5–6-fold reductions in the secretion of vascular endothelial growth factor (VEGF) by tumor cells correlated with the Ra values of microarc CaP-coated Ti substrates seems to limit surgical stress-induced metastasis of lymphoid malignancies.

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Bioceramic Bone Graft Substitute for Treatment of Unicameral Bone Cysts

Abstract: A single percutaneous injection of the bioceramic for UBC achieved good functional and radiological outcome while avoiding donor-site morbidity.

Cited by 8 publications

References 35 publications

Induced membrane technique combined with antibiotic-loaded calcium sulfate–calcium phosphate composite as bone graft expander for the treatment of large infected bone defects: preliminary results of 12 cases

Induced membrane technique combined with antibiotic-loaded calcium sulfate–calcium phosphate composite as bone graft expander for the treatment of large infected bone defects: preliminary results of 12 cases

Injection of a Bone Substitute in the Treatment of Unicameral Bone Cysts

Calcium Phosphate Coating Prepared by Microarc Oxidation Affects hTERT Expression, Molecular Presentation, and Cytokine Secretion in Tumor-Derived Jurkat T Cells

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