Composite Ceramic Bone Graft Substitute in the Treatment of Locally Aggressive Benign Bone Tumours

Abstract

Purpose. To report the use of a composite ceramic bone graft substitute containing calcium sulphate and hydroxyapatite (HA) in the treatment of large expansive osteolytic benign bone tumours. Methods. 4 women and 9 men aged 8 to 49 (mean, 22) years with aneurysmal bone cysts (n=6) or giant cell tumours (n=7) in the epi-or meta-physeal areas of the lower limbs underwent curettage, phenolisation, and filling with bone graft substitute containing calcium sulphate and HA. The mean tumour size was 38.5 (range, 18-65) ml. The patients were followed up for a mean of 41 (range, 33-52) months. Range of movement, Musculoskeletal Tumor Society Rating Score (MTSRS), and haematological and blood biochemical parameters were measured. Results. Two patients had recurrence at 7 and 9 months, both progressed to grade-III giant cell tumours. One underwent revision with an iliac crest autograft, whereas the other underwent en bloc excision and prosthetic replacement. The 11 other lesions displayed clinical and radiological consolidation

Function After Injection of Benign Bone Lesions with a Bioceramic

“…Kelly and Wilkins [16] presented a study of 15 patients with benign bone lesions treated with calcium sulfate who had an average MSTS functional evaluation of 83% with an average followup of 6 months. Schindler et al [27] reported findings for 13 patients treated with a composite ceramic bone graft substitute containing calcium sulfate and hydroxyapatite for benign bone tumors who had an Complications in our patients were infrequent and in most cases likely were not attributable to the graft material. Two patients sustained postoperative fractures that healed with nonoperative treatment, and two experienced wound complications that did not require removal of the graft material.…”

“…Unfortunately only a limited number of studies could be identified in the literature that investigated the MSTS functional evaluation of bone graft and bone graft substitutes in the treatment of benign bone lesions (Table 3) [1,11,14,16,27]. Aho et al [1] presented a study of 24 patients with benign bone lesions treated with an allograft who had an average MSTS functional evaluation of 83% with an average followup of 6 years.…”

“…One of the major factors in determining the quality of bone graft substitutes is the rate of graft incorporation into the host bone. Histologic assessment offers effective evaluation of the rate of graft incorporation but is considered impractical given the requirement of the patient to undergo an additional procedure for a bone biopsy [27]. The alternative to histologic analysis is radiographic assessment; however, the literature lacks defined standardized assessment guidelines for radiographic investigation of bone graft incorporation [27].…”

Increased osteogenesis with hydroxyapatite constructs combined with serially-passaged bone marrow-derived mesenchymal stem cells

“…Third, we used only HA in the present study. Other ceramics, such as β-tricalcium phosphate (β-TCP), are also commonly used clinically [27][28][29]. Therefore, other types of ceramics should be tested to confirm our results.…”

Shaped graft for aneurysmal bone cyst of upper-limb bones

“…The commonly used filling materials such as autogenous cancellous or corticocancellous bone graft, allogenic freeze-dried cancellous and cortical bone graft, PMMA and bone substitutes usually take the shape of the lesion resulting in a deformed bone with the possible limitation of function especially in the upper limb [12][13][14]. The current prospective study was conducted to evaluate the results of using bone grafts shaped to the original bone after extended [16] distal radius in two.…”