Nicholas R W, Lange T A
Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock 72205.
Clin Orthop Relat Res. 1994 Sep(306):197-203.
Development of an effective and safe bone grafting substitute could potentially alleviate many of the problems associated with human bone graft materials. Reported here are the results of 18 patients who were treated with a ceramic bone graft substitute, tricalcium phosphate. Twenty cavitary defects were created by intralesional curettage of a variety of benign bone neoplasms. Following complete removal of the tumor, each defect was filled with tricalcium phosphate granules. All patients were followed with periodic clinical and radiologic examinations for a minimum of 2 years (average followup of 37 months; range, 24 to 66 months). The amount of graft resorption and new bone formation were separately assessed on a percentage basis. Judged by radiographic criteria, the tricalcium phosphate implant lost its postoperative granular pattern in advance of bony trabeculae formation. Radiographic healing of defects with normal appearing bone was complete in four patients by 12 months, in an additional eight patients by 24 months, and in all except four patients by 48 months. Healing was dependent upon defect size; the larger lesions healing more slowly. Clinical parameters of healing were seen in advance of complete bone remodeling and all patients, except one, had unrestricted activity by 24 months. No adverse reactions were attributed to the graft material.
开发一种有效且安全的骨移植替代物可能会缓解许多与人类骨移植材料相关的问题。本文报告了18例接受陶瓷骨移植替代物磷酸三钙治疗的患者的结果。通过对各种良性骨肿瘤进行病灶内刮除术制造了20个空洞性缺损。在肿瘤完全切除后，每个缺损处填充磷酸三钙颗粒。所有患者均接受定期临床和放射学检查，随访至少2年（平均随访37个月；范围为24至66个月）。分别以百分比为基础评估移植骨的吸收量和新骨形成量。根据放射学标准判断，磷酸三钙植入物在骨小梁形成之前就失去了术后颗粒状形态。4例患者在12个月时缺损处出现正常骨的放射学愈合，另外8例患者在24个月时愈合，除4例患者外所有患者在48个月时愈合。愈合取决于缺损大小；较大的病变愈合较慢。在骨完全重塑之前就出现了愈合的临床指标，除1例患者外，所有患者在24个月时活动均不受限。未发现与移植材料相关的不良反应。
