Use of a Calcium Sulfate–Calcium Phosphate Synthetic Bone Graft Composite in the Surgical Management of Primary Bone Tumors

Abstract

Benign primary bone tumors are commonly treated with intralesional curettage with or without the use of surgical adjuvants. The reconstructive approach to the resulting contained bone defects is controversial, and clinical practice is varied. Synthetic bone substitutes may provide early mechanical support while minimizing the risks of disease transmission, nonunion, infection, and donor-site morbidity. Limited data exists regarding the use of calcium sulfate-calcium phosphate composite bone substitute for this purpose. The authors retrospectively reviewed the clinical outcomes of 24 patients with benign primary bone tumors who underwent intralesional curettage followed by reconstruction with a calcium sulfate-calcium phosphate composite bone substitute. Mean follow-up was 23 months. The most common diagnosis was giant cell tumor of bone. Six patients had upper-extremity tumors and 18 had lower-extremity tumors. Mean preoperative radiographic tumor volume was 41.0 cm(3). Mean volume of PRO-DENSE (Wright Medical Technology, Arlington, Tennessee) used in each patient was 15.6 cm(3). Mean time to full weight bearing for all patients was 7.3 weeks. Two patients sustained local tumor recurrences. No postoperative fractures occurred, and no complications occurred related to the use of the calcium sulfate-calcium phosphate composite. One case of deep infection occurred secondary to wound breakdown. The use of a calcium sulfate-calcium phosphate composite was associated with rapid biological integration and an early return to activities of daily living, with no composite-related complications. This technique is a viable option in the reconstruction of cavitary bone defects following intralesional curettage of primary benign bone tumors.

Calcium Sulfate as Bone Graft Substitute in the Treatment of Osseous Bone Defects, A Prospective Study

“…Calcium sulphate, calcium phosphate, bioactive glass, biodegradable polymers and recombinant human BMPs are all offered as solutions to the problem of bone healing. Calcium sulphate was used alone without bone graft or other additives [10][11][12][13][14][15][16][17]. Currently calcium sulphate is available as medical grade calcium sulphate.…”

“…An additional use for calcium sulfate is its reported use as a binding and stabilizing agent. The matrix is osteoconductive, which leads to new osseous in growth [16,17].…”

“…This osteoinductive property was related to local bone mineralization which occurs as a result of a reduction of the local pH. This demineralization leads to the release of osteoinductive molecules in the bone matrix stimulating healing process [16,17]. Most of the synthetic bone graft substitutes are not available in India and if available are very costly.…”

Equilibrium and kinetic studies of sorption of 2.4-dichlorophenol onto 2 mixtures: bamboo biochar plus calcium sulphate (BC) and hydroxyapatite plus bamboo biochar plus calcium sulphate (HBC), in a fluidized bed circulation column

“…A new composite material made from bamboo biochar plus calcium sulphate (BC), can be used as an adsorbent in that calcium sulphate plays a role on its hydrophilic property 14 . Hydroxyapatite, by itself or together with calcium sulphate -better known for their combined properties in the medical profession, particularly in bone surgery and bone treatment 15 , has reportedly been used more in the removal of heavy metals 16 , but less so in the removal of phenols 17 . As far as we know no literature has reported on the use of HBC in the removal of phenols either.…”

A comparative study of artificial bone graft versus allograft in the reconstruction of defects after benign tumor curettage.

“…Prodense ile tam radyolojik rezorbsiyon ve yeni kemik oluşumu tipik olarak postop 5. ayda görüldüğü saptanmıştır (12 Çalışmamızda küretaj ve greftleme ile tedavi edilen benign kemik tümörleri kitle boyutlarına göre sınıflandırılmamış ve bu anlamda istatistiksel veri elde edilmemiştir. Bu çalışmada periferik greft rezorbsiyonunun ve yeni kemik oluşumunun başlama süresi baz alınmıştır çünkü defektin tamamen konak kemikle konsolide olması kitle boyutlarıyla doğru orantılıdır.…”