Abstract
Substitutes for bone grafts experience increasing popularity, but the need for defect-filling following simple curettage of benign bone lesions is controversial. In this study, we wish to objectively report the radiological changes following bone defect-filling using a composite ceramic bone graft substitute, as well as the clinical results and complications. We evaluated 35 surgically treated benign bone lesions with subsequent defect-filling using two variants of a composite ceramic bone graft substitute (CERAMENT|BONE VOID FILLER or CERAMENT|G, BONESUPPORT AB, SWEDEN). After one year, a normal cortical thickness surrounding the defect was seen in approximately 80% of patients. Inside the defect-cavity, an almost complete product-resorption was seen after one year. The most common complication was a post-operative inflammatory soft-tissue reaction, seen in 7 patients (20%), which resolved without further treatment, although short-term antibiotic treatment was initiated at a local hospital in 6 patients, due to suspected wound infection. In summary, cortical thickness most commonly normalizes after bone tumor removal and filling of the bone defect using this particular composite ceramic bone graft substitute. The ceramic substitute undergoes resorption, which causes progressive changes in the radiological appearance inside the bone defect.
Highlights
No of patients/lesions Female/Male Age Defect size Campanacci grade 1 2 3 Histology (n = 35) Simple cysts* Enchondroma Bone infarction Intraosseous ganglion Aneurysmal bone cyst Giant cell tumor of bone Non-ossifying fibroma Giant cell granuloma Chondrosarcoma grade I Non-specific reactive lesion
We identified 34 patients (M/F = 17/17, mean age = 32 (5–69) years), who were treated for 35 benign (n = 32) or borderline bone-lesions (giant cell tumors of bone (n = 2) and chondrosarcoma grade 1 (n = 1)) (Table 1)
40% (11 of 28) of the defect-cavities showed normal radiological appearance after one year, whereas a normal cortical thickness was seen in 79% (22 of 28) of the cases (Table 2)
Summary
We aim to quantify changes in cortical thickness, as well as changes in the radiological appearance inside the defect cavity, following bone-defect filling, using a composite ceramic bone graft substitute (BGS), in the treatment of patients with bone-tumors and cysts
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