Yongkun Yang1, Xiaohui Niu2, Qing Zhang1, Lin Hao1, Yi Ding1, Hairong Xu1. 1. Department of Orthopedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Peking University, Beijing 100035, China. 2. Department of Orthopedic Oncology Surgery, Beijing Ji Shui Tan Hospital, Peking University, Beijing 100035, China. Email: niuxiaohui@bjmu.edu.cn.
Abstract
BACKGROUND: Cavity reconstruction after benign bone tumor removal is varied and controversial. Allograft is widely used but is associated with complications. New bone substitutes, such as calcium sulfate artificial bone, have been introduced for bone tumor operation. However, the bone healing response of artificial bone has not been compared with allograft bone. We therefore compared calcium sulfate grafts (study group) with bone allografts (control group) for the treatment of benign bone tumors. METHODS: We retrospectively reviewed 50 patients who underwent calcium sulfate reconstruction and 50 patients who underwent allograft cancellous bone reconstruction. The two groups were well matched. The mean follow-up time of the study group was 19.9 (12-55) months. We investigated bone healing response, complications, and factors affecting bone healing. RESULTS: At the last follow-up, 84% (42/50) of cases in the study group and 62% (31/50) of cases in the control group had achieved clinical healing (P = 0.013). The initial healing rate showed no significant difference between the two groups (100% vs. 96%, P = 0.153). The mean healing times for calcium sulfate and allograft bone were 9.6 (3-42) months and 13.8 (3-36) months, respectively (P < 0.01). Complications in the study group were minor and resolved. Implant volume was a significant factor affecting bone healing. CONCLUSION: The calcium sulfate bone substitute showed a satisfactory healing outcome and safety profile in reconstruction of bone defects after benign bone tumor curettage, especially in smaller cavities.
BACKGROUND: Cavity reconstruction after benign bone tumor removal is varied and controversial. Allograft is widely used but is associated with complications. New bone substitutes, such as calcium sulfate artificial bone, have been introduced for bone tumor operation. However, the bone healing response of artificial bone has not been compared with allograft bone. We therefore compared calcium sulfate grafts (study group) with bone allografts (control group) for the treatment of benign bone tumors. METHODS: We retrospectively reviewed 50 patients who underwent calcium sulfate reconstruction and 50 patients who underwent allograft cancellous bone reconstruction. The two groups were well matched. The mean follow-up time of the study group was 19.9 (12-55) months. We investigated bone healing response, complications, and factors affecting bone healing. RESULTS: At the last follow-up, 84% (42/50) of cases in the study group and 62% (31/50) of cases in the control group had achieved clinical healing (P = 0.013). The initial healing rate showed no significant difference between the two groups (100% vs. 96%, P = 0.153). The mean healing times for calcium sulfate and allograft bone were 9.6 (3-42) months and 13.8 (3-36) months, respectively (P < 0.01). Complications in the study group were minor and resolved. Implant volume was a significant factor affecting bone healing. CONCLUSION: The calcium sulfate bone substitute showed a satisfactory healing outcome and safety profile in reconstruction of bone defects after benign bone tumor curettage, especially in smaller cavities.