Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Department of Orthopaedics, University of Maryland, Baltimore, MD, USA.
J Orthop Surg (Hong Kong). 2024 May-Aug;32(2):10225536241254200. doi: 10.1177/10225536241254200.
The primary objective of this study was to determine time to full weight-bearing after the use of a calcium-sulfate-calcium phosphate bone substitute (CaSO4/CaPO4) as a bone void filler in the treatment of primary benign bone tumours following intralesional curettage. The secondary objectives were to determine surgical complications and recurrence rates.
Retrospective review of patients identified from a surgeon-specific orthopaedic oncology database, who underwent curettage of benign bone tumours and subsequent bone void filling with CaSO4/CaPO4.
A total of 39 patients (20 males, 19 females) met inclusion criteria with an average age of 31 years (range: 13 to 62 years), a median follow-up of 3.7 years, and a maximum follow-up of 11 years. The most common tumour diagnosis was giant cell tumour of bone (GCT) ( = 19), and the most common location was the proximal tibia ( = 9). The mean volume of tumour excised was 74.1 cm including extraosseous bone expansion due to tumour growth, with a mean of volume of 21.4 mL of CaSO4/CaPO4 used to fill the intraosseous cavitary defects to restore normal bone anatomy. None of the lesions required additional internal fixation. The primary outcome measure, average time to full weight-bearing/full range of motion, was 11 weeks and 6 weeks for upper and lower extremity lesions, respectively. Secondary outcomes included tumour recurrence requiring reoperation in five patients and infection requiring reoperation in two patients.
This study demonstrates that CaSO4/CaPO4 is a viable option as a bone void filler in the reconstruction of cavitary defects following removal of primary benign bone tumours. CaSO4/CaPO4 provides sufficient bone regeneration early in the post-operative period to allow progression to full weight-bearing within weeks without the need for internal fixation. There were no graft-specific complications noted.
本研究的主要目的是确定使用硫酸钙-磷酸钙（CaSO4/CaPO4）作为骨腔填充物治疗经腔内刮除的原发性良性骨肿瘤后完全负重的时间。次要目标是确定手术并发症和复发率。
回顾性分析了从特定外科医生的骨科肿瘤数据库中确定的患者，这些患者接受了良性骨肿瘤的刮除术，并随后使用 CaSO4/CaPO4 进行骨腔填充。
共有 39 名患者（20 名男性，19 名女性）符合纳入标准，平均年龄为 31 岁（范围：13-62 岁），中位随访时间为 3.7 年，最长随访时间为 11 年。最常见的肿瘤诊断为骨巨细胞瘤（GCT）（=19），最常见的部位是胫骨近端（=9）。切除的肿瘤平均体积为 74.1cm，包括因肿瘤生长而导致的骨外骨扩张，使用的 CaSO4/CaPO4 平均体积为 21.4ml，用于填充骨腔内的腔隙性缺损，以恢复正常的骨解剖结构。没有病变需要额外的内固定。主要结局测量指标为完全负重/完全活动范围的平均时间，分别为上、下肢病变的 11 周和 6 周。次要结局包括 5 例肿瘤复发需要再次手术，2 例感染需要再次手术。
本研究表明，CaSO4/CaPO4 是一种可行的选择，可作为原发性良性骨肿瘤切除后重建腔隙性缺损的骨腔填充物。CaSO4/CaPO4 在术后早期提供了足够的骨再生，使患者在数周内即可过渡到完全负重，而无需内固定。没有发现特定于移植物的并发症。
