Dragosloveanu Şerban, Dragosloveanu Christiana D M, Stanca Horia T, Cotor Dragoş C, Andrei Adrian C, Dragosloveanu Călin I, Stoica Cristian I
Department of Orthopedics, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Orthopedic Surgery, 'Foisor' Orthopedics-Traumatology and Osteoarticular TB Hospital, 030167 Bucharest, Romania.
Exp Ther Med. 2020 Dec;20(6):215. doi: 10.3892/etm.2020.9345. Epub 2020 Oct 15.
Benign bone tumors are surgically treated by curettage and by filling the defect using bone grafts or bone substitutes, such as hydroxyapatite crystals and tricalcium phosphate. The tricalcium phosphate mixed with hydroxyapatite, although fragile, is a good alternative with good integration. Fifteen patients with benign bone lesions were randomized in two groups surgically treated by curettage and filling of the bone defect using allograft (7 cases) or a mixture of 35% tricalcium phosphate, with 60-85% pore volume, and 65% hydroxyapatite (8 cases). After the surgery, all patients were followed up every 3 weeks until 6 months, and then at 2 months interval until one year for the clinical and radiological assessment. The average age was 35.4 years (from 18 to 54) for the allograft group and 41 years (from 22 to 58) for the patients treated with bone substitute. Eight patients were male and seven female, with relatively equal distribution between both groups. The average bone defect was relatively equal: 14 cc (4-25 cc) for the allograft group and 15.1 cc (4-33 cc) for the ceramic group (P>0.1). During the follow-up, all the lesions gradually disappeared after 12 months, with a time of healing of 18.8 weeks (15-24 weeks) for the allograft group and 20.37 weeks (15-28) for the bone substitute group. There were no significant differences regarding the clinical status and the radiological assessment after 12 months. No patient required extra pain medication after 2 weeks. No complications have been recorded. The surgical treatment of small and medium sized lytic benign tumors has good results with both types of graft that were studied. Using tricalcium phosphate mixed with hydroxyapatite as bone substitute represents a good and low cost alternative, but it is a relatively fragile material with a slower time to integrate compared to the allograft.
良性骨肿瘤通过刮除术进行手术治疗，并使用骨移植材料或骨替代物填充缺损，如羟基磷灰石晶体和磷酸三钙。与羟基磷灰石混合的磷酸三钙虽然易碎，但具有良好的整合性，是一种很好的替代物。15例良性骨病变患者被随机分为两组，分别接受刮除术并用同种异体骨（7例）或35%磷酸三钙与60 - 85%孔隙率的混合物及65%羟基磷灰石（8例）填充骨缺损的手术治疗。术后，所有患者每3周随访一次，直至6个月，然后每2个月随访一次，直至一年，进行临床和影像学评估。同种异体骨组的平均年龄为35.4岁（18至54岁），接受骨替代物治疗的患者平均年龄为41岁（22至58岁）。8例为男性，7例为女性，两组分布相对均衡。平均骨缺损相对相等：同种异体骨组为14立方厘米（4至25立方厘米），陶瓷组为15.1立方厘米（4至33立方厘米）（P>0.1）。随访期间，所有病变在12个月后逐渐消失，同种异体骨组的愈合时间为18.8周（15至24周），骨替代物组为20.37周（15至28周）。12个月后，临床状况和影像学评估无显著差异。2周后没有患者需要额外的止痛药物。未记录到并发症。对于研究的两种类型的移植物，中小型溶解性良性肿瘤的手术治疗都有良好的效果。使用与羟基磷灰石混合的磷酸三钙作为骨替代物是一种良好且低成本的选择，但与同种异体骨相比，它是一种相对易碎的材料，整合时间较慢。
