Conde Rodrigo Arruda, Silva Oliveira Filho André Richard, Machinski Elcio, Furtado da Cruz Vinícius, Melinte Marian Andrei, Varone Bruno Butturi, Pires de Camargo Olavo, Helito Camilo Partezani, Leal Daniel Peixoto
Fundación H.A. Barcelo, Instituto Universitario de Ciencias de La Salud, Buenos Aires, CABA, Argentina.
Universidade Federal da Paraíba (UFPB), João Pessoa - PB, Brazil.
J Orthop. 2025 Jun 3;69:208-215. doi: 10.1016/j.jor.2025.05.061. eCollection 2025 Nov.
Curettage followed by autografts or allografts has been the preferred method for treating benign bone tumors. However, the development of synthetic substances, such as bioactive glass (BAG), has prompted interest in the medical community. This meta-analysis of randomized controlled trial (RCTs) aimed to compare the adverse event rates between BAG and autograft or allograft following curettage for benign bone tumors.
We searched PubMed, EMBASE, and Cochrane Central for RCTs comparing BAG versus autograft or allograft after curettage for benign bone tumors. The primary endpoint was tumor recurrence. Secondary endpoints included rates of overall complications, mild complications, and reoperations. Risk ratios (RRs) with 95 % CIs were pooled across trials.
Four RCTs encompassing 156 patients were included, with 80 (51.3 %) receiving BAG. The most common lesions were enchondromas (24.4 %) and aneurysmal bone cysts (21.8 %). Recurrence rates were comparable between the BAG group (18.7 %) and the bone grafts (21.0 %) group (RR 0.91; 95 % CI 0.52 to 1.61; p = 0.75; I: 0 %). Reoperation (RR 1.53; 95 % CI 0.64 to 3.66; p = 0.34; I = 0 %), overall complications (RR 0.72; 95 % CI 0.46 to 1.13; p = 0.15; I = 0 %), and mild complications (RR 0.54; 95 % CI 0.16 to 1.86; p = 0.33; I = 21 %) were also comparable. Longer follow-up subanalysis showed analogous results.
BAG appears as effective as autografts or allografts regarding recurrence, reoperation, and complication rates after curettage of benign bone tumors. Larger RCTs with more standardized approaches are needed for validation.
刮除术联合自体骨移植或异体骨移植一直是治疗良性骨肿瘤的首选方法。然而，生物活性玻璃（BAG）等合成物质的发展引起了医学界的关注。这项随机对照试验（RCT）的荟萃分析旨在比较BAG与刮除术后自体骨移植或异体骨移植治疗良性骨肿瘤的不良事件发生率。
我们在PubMed、EMBASE和Cochrane Central数据库中检索比较BAG与刮除术后自体骨移植或异体骨移植治疗良性骨肿瘤的RCT。主要终点是肿瘤复发。次要终点包括总体并发症、轻度并发症和再次手术的发生率。各试验汇总了95%置信区间的风险比（RR）。
纳入了4项RCT，共156例患者，其中80例（51.3%）接受了BAG治疗。最常见的病变是内生软骨瘤（24.4%）和骨囊肿（21.8%）。BAG组（18.7%）和骨移植组（21.0%）的复发率相当（RR 0.91；95%置信区间0.52至1.61；p = 0.75；I² = 0%）。再次手术（RR 1.53；95%置信区间0.64至3.66；p = 0.34；I² = 0%）、总体并发症（RR 0.72；95%置信区间0.46至1.13；p = 0.15；I² = 0%）和轻度并发症（RR 0.54；95%置信区间0.16至1.86；p = 0.33；I² = 21%）也相当。更长随访时间的亚组分析显示了类似结果。
在良性骨肿瘤刮除术后的复发、再次手术和并发症发生率方面，BAG似乎与自体骨移植或异体骨移植一样有效。需要更大规模、方法更标准化的RCT进行验证。
