Pulatkan Anıl, Uçan Vahdet, Tokdemir Sevil, Elmalı Nurzat, Gürkan Volkan
Bezmi Alem Vakıf Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 34093 Fatih, İstanbul, Türkiye.
Jt Dis Relat Surg. 2020;31(2):335-340. doi: 10.5606/ehc.2020.71918. Epub 2020 Jun 18.
This study aims to investigate the effectivity of cement combined demineralized bone matrix (DBM) treatment on new bone formation in the cortical window as well as to evaluate the effect of new bone formation on functional outcomes.
Thirty-two benign bone tumor patients (15 males, 17 females; median age 38 years; range, 12 to 68 years), who were treated with cement combined DBM between February 2010 and December 2014, were evaluated retrospectively. Patient characteristics were recorded as age, gender, tumor localization, histological diagnosis, Enneking stage, tumor size, size of the cortical window, usage of prophylactic fixation, time to return to work, Musculoskeletal Tumor Society (MSTS) functional score, tumor relapse, and new bone formation on the cortical window in the computed tomography scans after one year of surgery.
Median tumor volume was 17.2 cm3 (range, 2.8 to 139.6 cm3), median area of the cortical window was 8.3 cm (range, 1.6 to 28.4 cm), and median postoperative one-year MSTS score was 84.5 (range, 66 to 97). MSTS scores were significantly worse with the usage of prophylactic fixation (p<0.001). There was a statistically significant difference between the usage of prophylactic fixation and cortical window size (p=0.013). There was a low-level negative correlation in terms of age and bone formation on the cortical window (p=0.046, r= -0.356) and mid-level negative correlation between cortical window size and functional scores (p=0.001, r= -0.577).
Application of cement combined with DBM procedure is an effective, alternative, and biological treatment in bone tumors that provides immediate stability and stimulates new bone formation on the cortical window.
本研究旨在探讨骨水泥联合脱矿骨基质（DBM）治疗对皮质骨开窗处新骨形成的有效性，并评估新骨形成对功能结局的影响。
回顾性评估2010年2月至2014年12月间接受骨水泥联合DBM治疗的32例良性骨肿瘤患者（男性15例，女性17例；中位年龄38岁；范围12至68岁）。记录患者的特征，包括年龄、性别、肿瘤位置、组织学诊断、Enneking分期、肿瘤大小、皮质骨开窗大小、是否使用预防性固定、恢复工作时间、肌肉骨骼肿瘤学会（MSTS）功能评分、肿瘤复发情况以及术后1年计算机断层扫描中皮质骨开窗处的新骨形成情况。
肿瘤体积中位数为17.2 cm³（范围2.8至139.6 cm³），皮质骨开窗面积中位数为8.3 cm（范围1.6至28.4 cm），术后1年MSTS评分中位数为84.5（范围66至97）。使用预防性固定时MSTS评分明显更差（p<0.001）。预防性固定的使用与皮质骨开窗大小之间存在统计学显著差异（p=0.013）。皮质骨开窗处的骨形成与年龄之间存在低水平负相关（p=0.046，r=-0.356），皮质骨开窗大小与功能评分之间存在中等水平负相关（p=0.001，r=-0.577）。
骨水泥联合DBM手术应用于骨肿瘤是一种有效、可替代的生物治疗方法，可提供即时稳定性并刺激皮质骨开窗处新骨形成。
