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用于刮除良性和低度恶性骨肿瘤的人工骨移植替代物:Cerasorb的临床和放射学经验

Artificial Bone Graft Substitutes for Curettage of Benign and Low-Grade Malignant Bone Tumors: Clinical and Radiological Experience with Cerasorb.

作者信息

Wittig Ulrike Susanne, Friesenbichler Jörg, Liegl-Atzwanger Bernadette, Igrec Jasminka, Andreou Dimosthenis, Leithner Andreas, Scheipl Susanne

机构信息

Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, Graz, Austria.

Department of Trauma Surgery, Wiener Neustadt State Hospital, Wiener Neustadt, Austria.

出版信息

Indian J Orthop. 2023 Jun 22;57(9):1409-1414. doi: 10.1007/s43465-023-00919-1. eCollection 2023 Sep.

Abstract

BACKGROUND

Artificial bone graft substitutes (ABGS) for curettage of bone tumors are becoming increasingly popular. The aim of this retrospective analysis was to determine the efficacy of the ABGS Cerasorb (Curasan-AG, Kleinostheim, Germany), a beta-tricalcium phosphate (beta-TCP), concerning resorption profile, bone healing, and remodeling after surgery and to evaluate potential complications.

METHODS

Forty-three patients suffering from benign and low-grade malignant bone tumors were treated with curettage and refilling of the bony cavity using the ABGS Cerasorb between 2018 and 2021 and included in the final analysis. Clinical follow-up exams with X-rays in two planes were performed 6 weeks, 3 months, 6 months, and 1 year after surgery.

RESULTS

After a mean follow-up period of 14.6 months, radiological consolidation following curettage was observed in all patients. Total resorption was observed in 16.3% of patients; in the other 83.7%, resorption was partial. In four patients, of whom two had a tumor in the distal femur and two in the humeral diaphysis, fractures occurred within 6 weeks after primary surgery.

CONCLUSION

In conclusion, the beta-TCP Cerasorb seems to be a reliable bone graft substitute with low complication rates and is a suitable alternative to autologous bone grafts or allografts. Nonetheless, it shows a tendency of delayed resorption.

LEVEL OF EVIDENCE

III; retrospective cohort study.

摘要

背景

用于骨肿瘤刮除术的人工骨移植替代物(ABGS)越来越受欢迎。本回顾性分析的目的是确定β-磷酸三钙(β-TCP)人工骨移植替代物Cerasorb(德国克莱诺施泰姆的Curasan-AG公司生产)在术后吸收情况、骨愈合和重塑方面的疗效,并评估潜在并发症。

方法

2018年至2021年间,43例患有良性和低度恶性骨肿瘤的患者接受了刮除术,并用ABGS Cerasorb填充骨腔,并纳入最终分析。术后6周、3个月、6个月和1年进行了包括两个平面X线检查的临床随访。

结果

平均随访14.6个月后,所有患者均观察到刮除术后的放射学骨愈合。16.3%的患者观察到完全吸收;在其他83.7%的患者中,吸收为部分吸收。4例患者在初次手术后6周内发生骨折,其中2例患者的肿瘤位于股骨远端,2例患者的肿瘤位于肱骨干。

结论

总之,β-TCP Cerasorb似乎是一种可靠的骨移植替代物,并发症发生率低,是自体骨移植或同种异体骨移植的合适替代品。尽管如此,它显示出延迟吸收的趋势。

证据水平

III级;回顾性队列研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb7a/10441831/d81d94f024b1/43465_2023_919_Fig1_HTML.jpg

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