Autosolidifying calcium phosphate cement in the repair of bone defects due to different etiology among 94 cases
- VernacularTitle:自固化磷酸钙人工骨修复不同病因骨缺损94例
- Author:
Hongwei CHEN
;
Gangsheng ZHAO
;
Jian YE
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2008;12(19):3779-3782
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Due to good biocompatibility, autologous bone has been considered as the optimal graft, but its source is too limited to meet the clinical requirements. In addition, the harvesting of iliac bone is associated with significant morbidity, thus searching for a substitute material of autologous bone graft is a current topic of study.OBJECTIVE: To study the biocompatibility and osteogenesis capacity of autosolidifying calcium phosphate cement (CPC) in the repair of bone defects.DESIGN, TIME AND SETTING: A self-control observation was performed among 94 patients who were admitted at the Department of Orthopedics in Yiwu Central Hospital (Yiwu, Zhejiang, China) from February 2001 to September 2004.PARTICIPANTS: Ninety-four patients with bone defects were involved in this study. The underlying cause of bone defects was fracture collapse and reduction in 63 cases, osteomyelitis in 20 cases, bone cyst in 6 cases, fibrous dysplasia in 4 cases and enchondroma in 1 case. The area of bone defects ranged from 1cm×1cm to 4cm×20cm.METHODS: CPC was the product of Shanghai Rebone Biomaterials Co., Ltd (License N0. 2005-3460304, China). CPC powder was mixed with solidifying liquid according to the ratio of 3.0g: 1mL, and the filling dose of CPC was 3-42g. There were 74 cases implanted with pure CPC, including 38 cases with thoracolumbar fracture undergoing vertebroplasty, 25 cases with fracture undergoing open repair, and 11 cases underwent focal debridement of benign bone tumor. in another 20 cases of osteomyelitis, drug-loaded CPC was implanted.MAIN OUTCOME M[EASURES: After the CPC implantation, all patients were observed according to the following indexes: allergic or toxic reaction, rash or high fever, levels of serum calcium, phosphors and alkaline phosphatase. X-ray radiography at month 12 after implantation was employed to observe the osseointegration of the implanted CPC to host bone and the degradation of CPC.RESULTS: All 94 patients were followed up for 14 months, and 76 of them for 24 months, 47 of them for 36 months, and 36 of them for 48 months. CPC developed primary solidification in human body within 30 minutes. Neither allergic or toxic reaction nor rash or high fever were found in all patients. The levels of serum calcium, phosphors and alkaline phosphatase were noted to be normal. No case companied with the itching in incision. The radiological examination showed that. the implanted CPC was directly bonded to the bone at the interface, and the bone contour at the defect sites was completely or partly restored. Degeneration and new bone were formed in some of the patients. Incision oozing light yellow fluids occurred in 9 cases, the bacterial culture was detected as negative, and all wounds healed through dressing changes. In the 20 cases implanted with drug-loaded CPC, no cases experienced recurrence of osteomyelitis and CPC degeneration was not complete.CONCLUSION: With good biocompatibility, safety and few complications, CPC is a good substitute for autologous bone graft in the repair of bone defects, and drug-loaded CPC is a selective treatment for osteomyelitis.
