使用硫酸钙-磷酸钙骨替代物作为骨空隙填充物治疗原发性良性骨肿瘤后的完全负重时间。

IF 1.6 4区 医学 Journal of Orthopaedic Surgery Pub Date : 2024-05-01 DOI:10.1177/10225536241254200
Lauren Gyemi, Asher Selznick, Brad Petrisor, Michelle Ghert
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引用次数: 0

摘要

目的:本研究的主要目的是确定在使用硫酸钙-磷酸钙骨替代物(CaSO4/CaPO4)作为骨空隙填充物治疗原发性良性骨肿瘤后,患者完全负重所需的时间。次要目标是确定手术并发症和复发率:方法:对外科医生特定的骨科肿瘤数据库中确定的接受良性骨肿瘤刮除术并随后使用 CaSO4/CaPO4 进行骨空隙填充的患者进行回顾性研究: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 至 62 岁),中位随访时间为 3.7 年,最长随访时间为 11 年。最常见的肿瘤诊断是骨巨细胞瘤(GCT)(19 例),最常见的部位是胫骨近端(9 例)。切除肿瘤的平均体积为74.1立方厘米,其中包括因肿瘤生长而导致的骨外骨膨胀,平均21.4毫升的CaSO4/CaPO4用于填充骨内空腔缺损,以恢复正常的骨解剖结构。没有一个病灶需要额外的内固定。主要结果是上肢和下肢病变完全负重/完全活动范围的平均时间分别为11周和6周。次要结果包括五名患者肿瘤复发需要再次手术,两名患者感染需要再次手术:本研究表明,CaSO4/CaPO4 是一种可行的骨空隙填充物,可用于原发性良性骨肿瘤切除后空腔缺损的重建。CaSO4/CaPO4能在术后早期提供足够的骨再生,使患者在数周内就能完全负重,而无需进行内固定。没有发现移植物特有的并发症。
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Time to full weight-bearing with the use of a calcium sulfate-calcium phosphate bone substitute as a bone void filler following extended curettage in the treatment of primary benign bone tumours.

Purpose: 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.

Methods: 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.

Results: 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) (n = 19), and the most common location was the proximal tibia (n = 9). The mean volume of tumour excised was 74.1 cm3 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.

Conclusion: 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.

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期刊介绍: Journal of Orthopaedic Surgery is an open access peer-reviewed journal publishing original reviews and research articles on all aspects of orthopaedic surgery. It is the official journal of the Asia Pacific Orthopaedic Association. The journal welcomes and will publish materials of a diverse nature, from basic science research to clinical trials and surgical techniques. The journal encourages contributions from all parts of the world, but special emphasis is given to research of particular relevance to the Asia Pacific region.
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