Alexis Moles1, Pierre Marie Heudes2, Aymeric Amelot3, Joseph Cristini4, Céline Salaud4, Vincent Roualdes4, Tanguy Riem4, Stéphane André Martin4, Sylvie Raoul5, Luc Terreaux4, Eric Bord4, Kevin Buffenoir5. 1. Neurosurgery and Neurotraumatology Department, Nantes University Hospital, Nantes, France. Electronic address: alexis.moles@neurochirurgie.fr. 2. Neuroradiology Department, Nantes University Hospital, Nantes, France. 3. Neurosurgery and Neurotraumatology Department, Nantes University Hospital, Nantes, France; Neurosurgery Department, Hôpital La Pitié Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France. 4. Neurosurgery and Neurotraumatology Department, Nantes University Hospital, Nantes, France. 5. Neurosurgery and Neurotraumatology Department, Nantes University Hospital, Nantes, France; Pain, Neuromodulation, and Quality of Life, INSERM EA3826, Nantes, France.
Abstract
OBJECTIVE: A three-dimensional reconstruction technique using the CustomBone (CB) prosthesis allows custom-made cranioplasty (CP) possessing osseointegration properties owing to its porous hydroxyapatite (HA) composition. This reconstruction technique has replaced less expensive techniques such as subcutaneously preserved autologous bone (SP). Our primary objective was to evaluate complications between CB and SP CP techniques. A secondary objective was to assess cosmetic results and osseointegration of CPs. METHODS: This single-center study comprised patients undergoing delayed CB or SP CP after craniectomy between 2007 and 2014. A prospective interview was conducted to collect all data, including 2-year follow-up clinical and radiologic data. Cosmetic results were assessed by a qualitative score, and osseointegration was assessed by measuring relative fusion at the CP margins. RESULTS: Of 100 patients undergoing CB or SP CP between 2007 and 2014, 92 (CB, n = 44; SP, n = 48) participated in the prospective interview. No significant difference in complication rates was observed between the 2 groups. The main complication specific to the CB group was fracture of the prosthesis observed in 20.8% patients. A higher rate of good cosmetic results was observed in the CB group (92.5% vs. 74.3%, P = 0.031). In the CB group, 51% of patients demonstrated no signs of bone fusion of the CP. CONCLUSIONS: Although the CB prosthesis is associated with cosmetic advantages, the porous hydroxyapatite composition makes it fragile in the short-term and long-term, and effective osseointegration remains uncertain.
OBJECTIVE: A three-dimensional reconstruction technique using the CustomBone (CB) prosthesis allows custom-made cranioplasty (CP) possessing osseointegration properties owing to its porous hydroxyapatite (HA) composition. This reconstruction technique has replaced less expensive techniques such as subcutaneously preserved autologous bone (SP). Our primary objective was to evaluate complications between CB and SP CP techniques. A secondary objective was to assess cosmetic results and osseointegration of CPs. METHODS: This single-center study comprised patients undergoing delayed CB or SP CP after craniectomy between 2007 and 2014. A prospective interview was conducted to collect all data, including 2-year follow-up clinical and radiologic data. Cosmetic results were assessed by a qualitative score, and osseointegration was assessed by measuring relative fusion at the CP margins. RESULTS: Of 100 patients undergoing CB or SP CP between 2007 and 2014, 92 (CB, n = 44; SP, n = 48) participated in the prospective interview. No significant difference in complication rates was observed between the 2 groups. The main complication specific to the CB group was fracture of the prosthesis observed in 20.8% patients. A higher rate of good cosmetic results was observed in the CB group (92.5% vs. 74.3%, P = 0.031). In the CB group, 51% of patients demonstrated no signs of bone fusion of the CP. CONCLUSIONS: Although the CB prosthesis is associated with cosmetic advantages, the porous hydroxyapatite composition makes it fragile in the short-term and long-term, and effective osseointegration remains uncertain.
Authors: Kacper Kroczek; Paweł Turek; Damian Mazur; Jacek Szczygielski; Damian Filip; Robert Brodowski; Krzysztof Balawender; Łukasz Przeszłowski; Bogumił Lewandowski; Stanisław Orkisz; Artur Mazur; Grzegorz Budzik; Józef Cebulski; Mariusz Oleksy Journal: Polymers (Basel) Date: 2022-04-09 Impact factor: 4.967