Sponer Pavel, Urban Karel, Urbanová Elen, Karpas Karel, Mathew Pradeep George
Department of Orthopaedic Surgery, Charles University, University Hospital, 500 05 Hradec Králové, Czech Republic.
Arch Orthop Trauma Surg. 2009 Oct;129(10):1353-60. doi: 10.1007/s00402-009-0839-3. Epub 2009 Feb 19.
The goal of this retrospective study was to compare the long-term results after implantation of the nonresorbable glass-ceramic material and transplantation of the cancellous allografts into the defects of long bones.
The bone cysts were excochleated and filled using granules of glass-ceramic material or cancellous allografts. Clinical, radiographic and scintigraphic examinations of 30 patients were carried out 2-14 years after their surgery.
Though signs of complete incorporation allowing full weight-bearing capacity were observed on plain radiographs, we detected pain in six out of nine patients after diaphyseal implantation of nonresorbable glass-ceramic. We found an increase in (99) (m)Tc-methylene diphosphonate uptake on the delayed images in the area of glass-ceramic implantation, mainly in its diaphyseal location. In patients after bone transplantation, the cancellous allografts were completely integrated and the scintigraphic findings were physiological.
The implantation of the nonresorbable glass-ceramic material into the diaphyseal defects of long bones is not suitable based on our study.
本回顾性研究的目的是比较不可吸收玻璃陶瓷材料植入和松质骨同种异体移植到长骨缺损后的长期结果。
刮除骨囊肿并用玻璃陶瓷材料颗粒或松质骨同种异体移植填充。对30例患者在手术后2至14年进行了临床、影像学和闪烁扫描检查。
尽管在X线平片上观察到完全融合并允许完全负重的迹象,但我们在9例骨干植入不可吸收玻璃陶瓷的患者中有6例检测到疼痛。我们发现在玻璃陶瓷植入区域的延迟图像上(99)(m)锝-亚甲基二膦酸盐摄取增加,主要在骨干部位。在骨移植后的患者中,松质骨同种异体移植完全整合,闪烁扫描结果正常。
根据我们的研究,将不可吸收玻璃陶瓷材料植入长骨骨干缺损是不合适的。