Kallala R, Harris W Edwin, Ibrahim M, Dipane M, McPherson E
Epsom and St Helier Hospitals NHS Trust, Carshalton, Sutton, UK.
Manchester Metropolitan University, Manchester, UK.
Bone Joint Res. 2018 Nov 3;7(10):570-579. doi: 10.1302/2046-3758.710.BJR-2017-0319.R1. eCollection 2018 Oct.
Calcium sulphate has traditionally been used as a filler of dead space arising during surgery. Various complications have been described following the use of Stimulan bio-absorbable calcium sulphate beads. This study is a prospective observational study to assess the safety profile of these beads when used in revision arthroplasty, comparing the complication rates with those reported in the literature.
A total of 755 patients who underwent 456 revision total knee arthroplasties (TKA) and 299 revision total hip arthroplasties (THA), with a mean follow-up of 35 months (0 to 78) were included in the study.
A total of 32 patients (4.2%) had wound drainage, and this was higher with higher bead volumes and in McPherson grade C patients. There was also a significantly higher bead volume in the 41 patients who developed hypercalcaemia, two of which were symptomatic (p < 0.0001). A total of 13 patients (1.7%) had heterotopic ossification (HO). There was no statistically significant relationship between the development of HO and bead volume (p > 0.05).
The strength of this study lies in the large number of patients and the detailed data collection, making it the most comprehensive report available in the literature on the use of calcium sulphate-based bone substitutes.: R. Kallala, W. Edwin Harris, M. Ibrahim, M. Dipane, E. McPherson. Use of Stimulan absorbable calcium sulphate beads in revision lower limb arthroplasty: Safety profile and complication rates. 2018;7:570-579. DOI: 10.1302/2046-3758.710.BJR-2017-0319.R1.
硫酸钙传统上被用作手术中出现的死腔填充物。使用Stimulan生物可吸收硫酸钙珠后出现了各种并发症。本研究是一项前瞻性观察性研究，旨在评估这些珠子在翻修关节成形术中使用时的安全性，将并发症发生率与文献报道的进行比较。
本研究共纳入755例患者，他们接受了456例全膝关节置换术（TKA）翻修和299例全髋关节置换术（THA）翻修，平均随访35个月（0至78个月）。
共有32例患者（4.2%）出现伤口引流，珠子体积越大以及麦克弗森C级患者中伤口引流情况更常见。41例发生高钙血症的患者珠子体积也显著更高，其中2例有症状（p<0.0001）。共有13例患者（1.7%）发生异位骨化（HO）。HO的发生与珠子体积之间无统计学显著关系（p>0.05）。
本研究的优势在于患者数量众多且数据收集详细，使其成为文献中关于使用硫酸钙基骨替代物的最全面报告。作者：R. Kallala、W. Edwin Harris、M. Ibrahim、M. Dipane、E. McPherson。《Stimulan可吸收硫酸钙珠在下肢关节置换翻修术中的应用：安全性和并发症发生率》。2018年；7:570 - 579。DOI: 10.1302/2046 - 3758.710.BJR - 2017 - 0319.R1 。
