Luke James Johnson1, Mark Clayer. 1. Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Abstract
INTRODUCTION: Reported strategies for void filling in bone include autograft, allograft, synthetic bone substitutes or various combinations of these materials, but poor response rates and donor morbidity have created a desire to find a better option. Calcium sulphate as a stand-alone graft material reconstruct bone following curettage has not been previously reported. The purpose of this study was to assess the efficacy and radiological quality of healing, the time to healing, the functional outcomes and the complications following curettage and grafting using an injectable aqueous calcium sulphate (BonePlast; Biomet, Warsaw, IN, USA) as the sole grafting strategy. METHODS: The procedure of curettage and grafting with an aqueous solution of calcium sulphate was undertaken. The patients were regularly reviewed clinically and radiologically for a minimum of 12 months (range: 12-85 months). Forty-six procedures in 46 patients were reviewed. Radiological outcomes of healing were established and functional outcomes were obtained from each patient at annual follow-up review. RESULTS: A complete response was seen in 38 patients (83%) at a median of 6 months following the procedure (range: 1-24 months). Seven patients (15%) displayed only a partial response after a median of 13 months post-surgery (range: 12-53 months). There was one non-response to treatment (2%) after 40 months of follow-up. The mean functional score was 99%. DISCUSSION: Aqueous calcium sulphate as a sole grafting agent for void management after curettage simplifies current treatment practices and displays good bone reconstruction in a comparatively short time frame, with excellent functional results and acceptable complication rates in the setting of tumour surgery.
INTRODUCTION: Reported strategies for void filling in bone include autograft, allograft, synthetic bone substitutes or various combinations of these materials, but poor response rates and donor morbidity have created a desire to find a better option. Calcium sulphate as a stand-alone graft material reconstruct bone following curettage has not been previously reported. The purpose of this study was to assess the efficacy and radiological quality of healing, the time to healing, the functional outcomes and the complications following curettage and grafting using an injectable aqueous calcium sulphate (BonePlast; Biomet, Warsaw, IN, USA) as the sole grafting strategy. METHODS: The procedure of curettage and grafting with an aqueous solution of calcium sulphate was undertaken. The patients were regularly reviewed clinically and radiologically for a minimum of 12 months (range: 12-85 months). Forty-six procedures in 46 patients were reviewed. Radiological outcomes of healing were established and functional outcomes were obtained from each patient at annual follow-up review. RESULTS: A complete response was seen in 38 patients (83%) at a median of 6 months following the procedure (range: 1-24 months). Seven patients (15%) displayed only a partial response after a median of 13 months post-surgery (range: 12-53 months). There was one non-response to treatment (2%) after 40 months of follow-up. The mean functional score was 99%. DISCUSSION: Aqueous calcium sulphate as a sole grafting agent for void management after curettage simplifies current treatment practices and displays good bone reconstruction in a comparatively short time frame, with excellent functional results and acceptable complication rates in the setting of tumour surgery.
Authors: Haley M McKissack; Jun Kit He; Tyler P Montgomery; John T Wilson; Aaradhana J Jha; Leonardo V Moraes; Ashish Shah Journal: Cureus Date: 2018-10-09