[EFFICACY OF BIOACTIVE GLASS AND ALLOGENIC BONE IN REPAIR OF BONE DEFECT AFTER BENIGN BONE TUMOR CURETTAGE].

OBJECTIVE

To compare the healing process and clinical results of bioactive glass and allogenic bone in the repair of bone defects after benign bone tumor curettage.

METHODS

Between November 2011 and December 2012, 20 patients with benign bone tumor received bioactive glass and allogenic bone for repair of bone defects after benign bone tumor curettage. There were 17 males and 3 females, aged 9-68 years (median, 18.5 years). The mean course of disease was 3.3 months (range, 1-9 months). Pathological examination revealed that there were 7 cases of chondroblastoma, 5 cases of bone cyst, 2 cases of non-ossifying fibroma, 2 cases of enchondroma, 1 case of vascular tumor of bone, 1 case of lipoma of bone, 1 case of osteoid osteoma, and 1 case of chondromyxoid fibroma. The lesion located at the femur in 5 cases, at the tibia in 11 cases, at the humerus in 1 case, at the calcaneus in 2 cases, and at the talus in 1 case. The bioactive glass and allogenic cancellous bone were implanted in the cavity at the same time. The Musculoskeletal Tumor Society (MSTS) function evaluation score was used for evaluation of postoperative limb function. According to the imaging and clinical benefit, the healing processes of two kinds of implants were evaluated. The healing rate and healing time were compared. The distribution of the bioactive glass was divided into two layers: the layer close to host bone and the layer close to allogenic bone. The bone ingrowth time and bone resorption time in different layers were evaluated and compared.

RESULTS

All cases were followed up 12-42 months (mean, 34.5 months). All incisions healed by first intention. There were no complications of wound infection or deep infection, rejection, nonunion of bone, fracture at bone graft site, and collapsing of articular surface. There was no tumor recurrence during follow-up. The mean MSTS functional score was 29.5 (range, 28-30) at last follow-up. Complete healing was observed in 11 cases and healing in 9 cases. The healing rates of two kinds of implants were both 100%. The healing time of bioactive glass and allogenic bone was (4.7±1.3) months and (5.2±1.6) months, respectively, showing no significant difference (=-1.240, =0.244). The bone ingrowth time and the bone absorption time were (3.6±0.9) months and (3.7±1.0) months in the layer close to host bone and were (4.2±1.3) months and (4.2±1.3) months in the layer close to allogenic bone, all showing no significant difference (=1.785, =0.097; =1.476, =0.172).

CONCLUSIONS

For the repair of bone defects after benign bone tumor curettage, bioactive glass can achieve satisfactory healing result and has good safety.