Autologous, and combined autologous, and hydroxyapatite granules in the treatment of benign bone lesions in children

Abstract

Background Despite all established treatments, large bone cysts in children remain an unsolved problem. Bone grafts are often necessary to fill the defect, provide support, and enhance biological repair. Autogenous cancellous bone grafts usually from the iliac crest have been considered the gold standard. However, the limited quantity of a bone graft especially in children may limit its use. Calcium phosphate ceramics can be used to fill bone defects. These materials act as an osteoconductive bone-void filler that completely gets resorbed as newly formed bone remodels and restores anatomic features and structural properties. Aim of the work This study was carried out to assess the results of treatment of benign bone lesions in children using autologous bone graft either alone or in combination with hydroxyapatite (HA) granules. Patients and methods The study included 18 children having benign bone lesions. Their age ranged from 5 to 15 years (mean, 8.2±1.59 years). The resultant defect was filled with autogenous iliac crest graft in five (27.8%) patients in group I, and a combination of autogenous bone graft and G-bone HA granules in 13 (72.2%) patients in group II. The defect size ranged from 6 to 17 cm3 in group I (mean, 9.75±43.86 cm3), and from 11.5 to 115.5 cm3 in group II (mean, 43±33.92 cm3). The patients were followed up clinically and radiologically for a period that ranged from 12 to 56 months (mean, 17±11.41 months). Results The overall success rates were 80% for group I (four out of five) and 92.3% for group II (12 out of 13). Recurrence was met in one (20%) of five patients in group I, and one (7.7%) of 13 patients in group II. At the final follow-up, four of five patients in group I (80%) were considered Neer class I, and one (20%) patient was considered Neer class IV. Ten (77%) of 13 patients in group II were considered Neer class I, two (15.3%) patients were Neer class II, and one (7.7%) was Neer class IV. The differences in the results of both groups were statistically insignificant. Conclusion The use of HA synthetic granules with autogenous bone graft is a safe and effective option for the situations when a large amount of graft is needed especially in children with large and recurrent benign bone lesions.