Clunk Marilee J, Gonzalez Marcos R, Denwood Hayley M, Werenski Joseph O, Sodhi Alisha, Hoffman Brett A, Merchan Nelson, Lozano-Calderon Santiago A
Musculoskeletal Oncology Service, Department of Orthopaedic Surgery, Massachusetts General Hospital Boston, MA, 02114, USA.
University of Toledo College of Medicine and Life Sciences Toledo, OH, 43614, USA.
J Orthop. 2023 Sep 29;45:13-18. doi: 10.1016/j.jor.2023.09.011. eCollection 2023 Nov.
The use of carbon fiber implants in orthopaedic oncology has increased within recent years. The most widely used type of polymer is carbon fiber polyether ether ketone (CF-PEEK). Its radiolucency enables targeted radiotherapy and artifact-free tumor surveillance, which provides major advantages over metallic hardware. We aim to summarize the unique benefits within orthopaedic oncology, clinical pitfalls, and recent advancements.
Four representative patient cases from a single tertiary academic medical center were treated with carbon fiber implants (n = 2 nails, n = 2 plates) from 2021 to 2022.
There were no adverse events noted during intraoperative implantation or postoperative follow up. All patients reported improvements in pain and no difficulties in ambulation. There were no instances of catastrophic failure or implant loosening.
CF implants offer a diverse array of advantages regarding its radiolucency, low scatter density, and bioinert profile. Nonetheless, further research is required to understand the long-term surgical outcomes and robustness of CF implants. Multi institutional trials could address important aspects of durability and stability over extended periods, feasibility and ease-of-use for different anatomical sites and bone quality, as well as cost-effectiveness in post-operative imaging, healthcare resource utilization, and revision rates. Providing orthopaedic surgeons with valuable insight will enable thorough clinically supported, informed decision making regarding optimal use of implants.
近年来，碳纤维植入物在骨肿瘤学中的应用有所增加。使用最广泛的聚合物类型是碳纤维聚醚醚酮（CF-PEEK）。其射线可透过性有助于进行靶向放疗和无伪影的肿瘤监测，这比金属硬件具有显著优势。我们旨在总结其在骨肿瘤学中的独特益处、临床缺陷及最新进展。
2021年至2022年期间，来自一家单一的三级学术医疗中心的4例代表性患者接受了碳纤维植入物治疗（2枚钉子，2块钢板）。
术中植入及术后随访期间均未发现不良事件。所有患者均报告疼痛有所改善，行走无困难。未发生灾难性失败或植入物松动的情况。
CF植入物在射线可透过性、低散射密度和生物惰性方面具有多种优势。尽管如此，仍需要进一步研究以了解CF植入物的长期手术效果和耐用性。多机构试验可以解决长期的耐用性和稳定性、不同解剖部位及骨质的可行性和易用性，以及术后成像、医疗资源利用和翻修率方面的成本效益等重要问题。为骨科医生提供有价值的见解将有助于在临床上做出充分支持、明智的关于植入物最佳使用的决策。
