Porous alumina ceramic sternum: A reliable option for sternal replacement

Abstract

CONTEXT:To date, there is no gold standard technique for sternum replacement. Current techniques rely on metallic prosthesis, meshes and bars, or bone grafts. However, they have several pitfalls.AIMS:The aim of this article is to report the results of sternal replacement with a porous alumina ceramic sternum.SETTINGS AND DESIGN:Surgeries were performed in two teaching hospitals in France.METHODS:We designed a porous alumina ceramic prosthesis which possesses interesting characteristics for this surgery such as great biocompatibility, a certain level of bacterial resistance, radiolucency, and compatibility with radiotherapy. The implant is stitched to the ribs with suture thread and does not require osteosynthesis material.RESULTS:Six patients with a mean age of 60.6 years received this prosthesis. Indication was tumor in five cases and mediastinitis in one case. The mean follow-up is 20 months (3–37 months). No major complication occurred and healing was fine for all patients. Patients did not complain of breathing discomfort or pain related to the prosthesis.CONCLUSIONS:This new technique is promising even if there are only six patients in this study.

First Sternal Cleft Repair Using a Porous Alumina Ceramic Prosthesis in a 9-Year-Old Child

“…These surgeries were performed in other hospitals in France for adult patients with a mean age of 58 years (range, 38–79 years). 7 Indications were sternal cancer involvement ( n = 8) or refractory deep sternal wound infection ( n = 3). At the time of this surgery, the mean follow-up of these patients was 18 months with the older one dating from 3 years.…”

“…For those attractive reasons and the adult experience, 7 we decided to try this new material in this rare condition. The rigidity of the ceramic with the smooth anchorage using suture threads avoids chest instability while giving elasticity.…”

“…Recently, a ceramic sternal prosthesis was designed to replace sternum when removed for tumor or infectious reasons. 7 We describe this new surgical option to fix this sternal defect.…”

An antibiotic loaded ceramic sternum to treat destroyed infected sternum: 4 cases

“…The device is the combination of two compounds. First, a porous ceramic (referred to as "alumina") which has been shaped to replace the sternum (Figure 2) (8). It is made of alumina which is an inert, biocompatible and non-absorbable ceramic (10,11).…”

“…The surgical technique was divided in several steps (8). After debridement of the infected area and removal of necrotized tissues (Figure 2A), trial implants were used to choose the size of the device and to prepare the area for implantation (Figure 2B).…”