The fate of a macroporous hydroxyapatite cranioplasty four years after implantation: Macroscopical and microscopical findings in a case of recurrent atypical meningioma

Frassanito, Paolo; Bonis, Pasquale De; Mattogno, Pier Paolo; Mangiola, Annunziato; Novello, Mariangela; Brinchi, Domenico; Pompucci, Angelo; Anile, Carmelo

doi:10.1016/j.clineuro.2012.11.032

Cited by 30 publications

(14 citation statements)

References 8 publications

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“…However, in comparison with other artificial bone, there is not much evidence for osteointegration of HAp implants for humans in vivo . [ 4 19 ] One of the reasons for this is that there are few reports of new bone formation. New bone formation in vivo using HAp implants was observed in only 4 cases.…”

Section: Discussionmentioning

confidence: 99%

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Histological assessment of porous custom-made hydroxyapatite implants 6 months and 2.5 years after cranioplasty

et al. 2017

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Background:In cranial reconstruction, the features of artificial bone differ. Custom-made porous hydroxyapatite (HAp) implants for cranioplasty have been used all over the world because of their good cosmetic, biocompatibility, and osteoconductive properties. Surgical techniques were analyzed, and histological assessment of new bone formation in the hydroxyapatite was performed.Methods:Over a 6-year time period, 41 patients underwent cranioplasty using a custom-made three-dimensional hybrid pore structured hydroxyapatite (3DHPoHAp) implant. The surgical techniques and histological evaluations of 3DHPoHAp in 2 cases, removed 6 months and 2.5 years after cranioplasty, are described.Results:Using 3DHPoHAp, cranioplasty was successfully performed for all patients. The implant fit the bone defect exactly, and surgical manoeuvres were simple and easy. All implants were firmly fixed using a titanium plate, and postoperative infection occurred in 1 patient (2.4%). New bone formation was seen in 2 cases 6 months and 2.5 years after cranioplasty. Osteoblasts were progressing to the stoma at various depths, and bone tissue had ripened. Furthermore, lamellar structure was observed in the case at 2.5 years.Conclusions:In this study, there was a low infection rate, and new bone formation was seen in vivo after cranioplasty. This study also demonstrated that the 3DHPoHAp implant is a good candidate for cranial bone implants because its good osteoconductivity and biocompatibility.

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Section: Discussionmentioning

confidence: 99%

“…New bone formation in vivo using HAp implants was observed in only 4 cases. [ 4 5 12 ] Information regarding the implant was confirmed in some of the reports,[ 4 5 11 13 15 20 21 ] however, there were only limited descriptions of properties such as porosity and thickness of the artificial implant.…”

Section: Discussionmentioning

confidence: 99%

Histological assessment of porous custom-made hydroxyapatite implants 6 months and 2.5 years after cranioplasty

et al. 2017

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“…25 Hydroxylapatite is prone to fragmentation over time, however, and as such is best suited to smaller defects. 26 Also, hydroxylapatite should never be placed directly on the dura. 1 Similarly, because of its risk of infection, it should not be placed in contact with the frontal sinus or aerodigestive tract.…”

Section: Hydroxylapatitementioning

confidence: 99%

Management of Skull Fractures and Calvarial Defects

et al. 2019

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Scalp and calvarial defects can result from a myriad of causes including but not limited to trauma, infection, congenital malformations, neoplasm, and surgical management of tumors or other pathologies. While some small, nondisplaced fractures with minimal overlying skin injury can be managed conservatively, more extensive wounds will need surgical repair and closure. There are many autologous and alloplastic materials to aid in dural and calvarial reconstruction, but no ideal reconstructive method has yet emerged. Different reconstructive materials and methods are associated with different advantages, disadvantages, and complications that reconstructive surgeons should be aware of. Herein, we discuss different methods and materials for the surgical reconstruction of calvarial defects.

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“…47 A disadvantage of hydroxyapatite is a lack of lamellar organization; a low tensile strength implant is prone to fragmenting over time. 43,48 As a result, it is commonly used for smaller calvarial defects. 49,50 Polyetheretherketone Polyetheretherketone (PEEK) is a chemically inert semicrystalline powder.…”

Section: Hydroxyapatitementioning

confidence: 99%

Calvarial Reconstruction

Badhey

Kadakia

Mourad

et al. 2017

Seminars in Plastic Surgery

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Calvarial reconstruction is a challenge to reconstructive surgeons, especially considering protection of intracranial contents. In recent years, the advent of multiple reconstructive materials adds tools to the surgical armamentarium. Options include autologous split calvarial and rib grafts and alloplastic materials such as titanium mesh, methyl methacrylate, calcium hydroxyapatite, and polyetheretherketone. The most important aspect of cranial reconstruction still lies in finding the most aesthetic, safe, and reliable means of filling a defect.

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The fate of a macroporous hydroxyapatite cranioplasty four years after implantation: Macroscopical and microscopical findings in a case of recurrent atypical meningioma

Cited by 30 publications

References 8 publications

Histological assessment of porous custom-made hydroxyapatite implants 6 months and 2.5 years after cranioplasty

Histological assessment of porous custom-made hydroxyapatite implants 6 months and 2.5 years after cranioplasty

Management of Skull Fractures and Calvarial Defects

Calvarial Reconstruction

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