Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna General Hospital, Währinger Gürtel 18-20, A-1090, Wien, Österreich.
Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Wien, Austria.
BMC Musculoskelet Disord. 2022 Oct 8;23(1):901. doi: 10.1186/s12891-022-05843-3.
Injectable biphasic ceramic bone substitutes (BCBSs) represent a modern alternative to conventional options for bone defect filling, as they further open the possibilities for percutaneous cavity reconstruction. Although recent studies have shown good surgical outcomes after treatment with BCBSs, mid-term follow-up data are still missing.
Between 2013 and 2017, 18 patients were [1] treated with BCBS [2] for benign bone lesions and [3] had a complete set of retrospective information, including surgical protocols, imaging, patient dismission letters and outpatient clinic protocols, [4] with a minimum follow-up time of one year. Eleven patients received percutaneous surgery, while 7 patients had open curettage and BCBS filling. The median follow-up time was 36.5 (range 12-80) months.
Local recurrence was reported in four patients. A distinctive bone remodelling pattern was noted on follow-up X-ray and magnetic resonance imaging showing a double-line phenomenon and continuously increasing cortical thickness one year after treatment in nine of thirteen patients. Regarding surgical complications, one patient suffered from a septic complication that required BCBS removal and lavage. One patient experienced superficial surgical site inflammation with redness and swelling, while two other patients had prolonged wound secretion.
In a limited case series, the studied BCBS demonstrated acceptable surgical outcomes. Initial wound leakage and recurrence seemed to be associated with percutaneous injection. Further studies are needed to compare recurrence and bone graft resorption after open and percutaneous bone cyst surgeries and to further evaluate postoperative surgical site inflammation, which appears self-limiting in most cases.
注射型双相陶瓷骨替代物（BCBS）代表了一种替代传统骨缺损填充方法的现代选择，因为它进一步扩大了经皮腔重建的可能性。尽管最近的研究表明，BCBS 治疗后的手术效果良好，但仍缺乏中期随访数据。
2013 年至 2017 年间，18 名患者因良性骨病变接受了 BCBS 治疗[1]，并具有完整的回顾性信息，包括手术方案、影像学、患者出院信和门诊随访方案[2]，随访时间至少为一年。11 名患者接受了经皮手术，7 名患者接受了开放性刮除和 BCBS 填充。中位随访时间为 36.5 个月（范围 12-80 个月）[3]。
4 名患者报告局部复发。在 13 名患者中的 9 名中，随访 X 射线和磁共振成像显示出一种独特的骨重塑模式，表现为双线条现象和皮质厚度持续增加，在治疗后一年[4]。关于手术并发症，1 名患者发生感染性并发症，需要去除和冲洗 BCBS。1 名患者出现浅表手术部位炎症，表现为红肿，2 名患者出现伤口分泌物延长。
在一项有限的病例系列研究中，研究中的 BCBS 显示出可接受的手术效果。最初的伤口渗漏和复发似乎与经皮注射有关。需要进一步的研究来比较开放性和经皮骨囊肿手术后的复发和骨移植物吸收情况，并进一步评估术后手术部位炎症，在大多数情况下，这种炎症似乎是自限性的。
