Bone Cement In Treatment Research Articles

Evaluation of Antibiotic-Loaded Bone Cement in Treatment of Infected Diabetic Foot: Systematic Review and Meta-Analysis.

Diabetic foot ulcer (DFU) is a common and complex complication in patients with diabetes mellitus. The study of antibiotic-loaded bone cement for the treatment of infected diabetic foot is limited. We aimed to assess the efficacy of antibiotic-loaded bone cement for the treatment of infected diabetic foot. The MEDLINE, Embase, BIOSIS, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Knowledge databases were systematically searched up to May 2023 with no language restrictions. We assessed eligible studies for the efficacy of antibiotic-loaded bone cement for the treatment of infected diabetic foot. The standard mean differences (SMDs) or the risk ratios (RRs) were calculated for continuous or dichotomous data, respectively. Data were analysed using the Cochrane Collaboration's RevMan 5.0 software. Nine articles with 565 patients were analysed in our meta-analysis. The wound healing time in ABC group was significantly shorter than that in the control group (SMD=-1.64, 95% CI -2.27 to -1.02 p<0.00001, I2=88%). The ABC group had a significantly decreased number of debridements (SMD=-2.47, 95% CI -4.24 to -0.70, p<0.00001, I2=95%). The pooled data showed no significant difference (RR=0.41, 95% CI 0.12 to 1.39, p=0.84, I2=0%). This is the first meta-analysis comparing the efficacy of antibiotic-loaded bone cement for the treatment of infected diabetic foot. Antibiotic-loaded bone cement treatment significantly shortened the wound healing time and reduced the number of debridements without increasing the incidence of complications. PROSPERO CRD42023406017.

Application of Mirror Image 3D-Printing Technology Bone Cement in Treatment of Stage IIIb Necrosis of the Lunate Bone.

At present, conventional operations are weak for pain relief and restoring the carpal joint function in the treatment of avascular necrosis of the lunate bone. Mirror image 3-dimensional (3D)-printing technology has rarely been reported for the treatment of lunate bone necrosis, The use of mirror 3D-printed lunar bone replacement and bone cement technology in the treatment of stage IIIb lunar bone necrosis has been rarely reported in previous literature. Personalized customized 3D-printed prostheses have become an effective solution for solving many complex cases, and the flexible application of bone cement technology can also achieve satisfactory clinical results. The authors report 3 patients who underwent mirror printing of lunar bone prostheses based on healthy side lunar bone computed tomography data, 3D printing of lunar bone prostheses replacement through small incisions, and intraoperative selection of alternative bone cement technology based on actual conditions. Mirror image 3D printing relieved the pain and resulted in satisfactory functional recovery for stage IIIb lunate bone necrosis.

Analyses of the efficacy of percutaneous kyphoplasty and alendronate sodium on thoracolumbar vertebral fracture and the risk factors of fracture.

The present study investigated the efficacy of percutaneous kyphoplasty and alendronate sodium on thoracolumbar vertebral fracture, and the risk factors leading to the recurrence of fracture. In the present study, a total of 80 patients with thoracolumbar vertebral fracture who were admitted to the Affiliated Jiangyin Hospital of Southeast University Medical College between January 2014 and March 2016 for combination treatment of percutaneous kyphoplasty and alendronate sodium were enrolled. According to the recurrence of fracture, the patients were divided into two groups, the observation group (patients with fracture recurrence, n=40) and control group (patients with no fracture recurrence, n=40). All patients participated in a 1-year follow-up. The recurrence of fracture and the site of fracture were identified through the clinical symptoms and examination of the spine using magnetic resonance imaging. In addition, comparisons of the time of alleviation in numbness of lower limb and that in pains in waist and legs were carried out. Furthermore, statistics on the adverse reactions during intervention in the two groups were also collected; changes in visual analogue scale (VAS) and Oswestry Disability Index (ODI) of pains at different time points in two groups were also observed. One-way analysis and multivariate analysis were performed to identify the relevant risk factors. Alleviation time in numbness of lower legs in patients of the control group was significantly earlier than that in the observation group (P<0.05) and the alleviation time in pains of the waist and legs of patients in the control group was also significantly earlier than that in the observation group (P<0.05). Furthermore, the incidence rates of abdominal pain, diarrhea, constipation and hypocalcemiain in the control group were also significantly lower compared with those in the observation group (P<0.05). One week, one month and one year after operation, the scores of VAS of pains and ODI in the control group were significantly lower compared with those in the observation group in the same period (P<0.05). Lower preoperative bone density and exosmosis of bone cement in treatment were the independent risk factors leading to the recurrence of fracture. For patients with thoracolumbar vertebral fracture who received the combination treatment of percutaneous kyphoplasty and alendronate sodium, there underlies an important correlation between the recurrence rate of fracture and the preoperative bone density as well as the exosmosis of bone cement in operation.

Intramedullary nail combined with auxiliary plate and bone cement in treatment of pathologic fracture of extremities caused by metastatic tumors

To explore the application of intramedullary nail fixation combined with auxiliary plate and bone cement in the palliative treatment of pathologic fracture of extremities caused by metastatic tumors. Clinical data of 11 cases with pathologic fracture of extremities caused by metastatic tumors between April 2015 and October 2016 were retrospectively analyzed. All the patients were treated by intramedullary nail fixation combined with auxiliary plate and bone cement. There were 6 males and 5 females with an age of 54-72 years (mean, 62.9 years). The disease duration was 1.0-1.5 months. Of the 11 patients, 4 metastatic tumors were diagnosed at humerus, 6 at femur, and 1 at tibia, respectively. And the tumor infiltration length ranged from 3.3 to 5.6 cm (mean, 4.6 cm), the depth could reach the bilayer of limb bones. All the patients had suffered the limbs pain and incapability of physical movement. The preoperative visual analogue scale (VAS) score was 6.36±1.03, and the Karnofsky Performance Status (KPS) score was 42.73±10.09. The operation time, intraoperative blood loss, and postoperative complications were recorded. The VAS score, KPS score, and Musculoskeletal Tumor Society (MSTS) score were used to evaluate the effectiveness at 3 months after operation. The operation time was 1.1-1.8 hours (mean, 1.5 hours), the intraoperative blood loss was 102.5-211.3 mL (mean, 135.6 mL). Postoperative limb incisions healed well without infection, necrosis, and delayed healing or other complications. All the patients were followed up 7-10 months (mean, 8.2 months). At 3 months after operation, the functions of limbs recovered. The VAS score decreased to 0.82±0.75 and the KPS score increased to 85.45±5.22, both showing significant difference when compared with preoperative ones ( t=35.218, P=0.000; t=-18.470, P=0.000); and the MSTS score was 23.91±2.47. At last follow-up, the anteroposterior and lateral X-ray films showed that all the limbs healing well and no breakage of intramedullary nail and steel plate, or loosening in bone cement, limb shortening, malalignment, or other complications occurred. In treating metastatic tumors of extremities, the combination of intramedullary nail fixation with auxiliary plate and bone cement will contribute to an invariable length and fixed location for limbs, resulting in biomechanical stability for skeleton. Under this premise, the tumor lesions can be eliminated and pathological pains be relieved, so as to improve patients' life quality.

Efficacy and safety of bone cement in treatment of advanced malignant tumors with vertebral metastasis

目的 观察骨水泥治疗晚期恶性肿瘤椎体转移的效果和安全性。 方法 对2010年1月至2014年12月接受骨水泥治疗的30例恶性肿瘤椎体转移患者进行回顾性分析。分别在骨水泥治疗前24 h及术后12 h、24 h、7 d、1个月、3个月、6个月、12个月利用测量数值评分量表（NRS）评估患者疼痛的缓解情况，利用Karnofsky评分法评估患者生命质量的改善情况，并观察有无严重的并发症。 结果 所有患者在接受骨水泥治疗后疼痛均缓解。NRS评分提示治疗后12 h患者疼痛明显缓解[（2.13±0.92）分]，24 h疼痛控制稳定[（1.77±0.92）分]，随访期间所有接受骨水泥治疗的椎体均无疼痛复发。Karnofsky评分提示治疗后12 h[（66.67±9.07）分]开始30例患者生命质量均有不同程度改善，治疗后6个月开始部分患者生命质量开始下降，均死于肿瘤复发转移。其中1例患者发生无症状骨水泥椎体外渗漏，其余患者均无并发症发生。随访期间所有患者均无局部肿瘤复发。 结论 骨水泥能快速缓解恶性肿瘤骨转移引起的疼痛，改善患者生命质量，且具有良好的安全性。

Effect of percutaneous vertebroplasty with high-viscosity bone cement in treatment of severe osteoporotic vertebral compression fractures

Objective To evaluate the clinical effects of percutaneous vertebroplasty (PVP) with high-viscosity bone cement in treatment of severe osteoporotic vertebral compression fracture (OVCF). Methods This study involved 176 patients with severe OVCF treated by PVP with high-viscosity bone cement between January 2013 and January 2015. There were 61 male and 115 female patients, aged 58-78 years (mean, 67.7 years). Ninety-four patients were injured in a fall, 31 patients in a bumping condition, and 61 patients with no obvious causes. A total of 204 vertebrae were involved, including 23 T10, 22 T11, 49 T12, 43 L1 and 29 L2. Thirty patients suffered vertebral posterior wall damage. All the vertebral bodies were compressed more than 2/3. Vertebral height, kyphotic Cobb angle, visual analogue scale (VAS) and Oswestry disability index (ODI) were recorded. Bone cement filling and leakage were detected. Results Bone cement leakage was detected in 64 patients, with a leakage rate of 36.3%.Seven patients were found with cement leakage in paravertebral veins, 38 patients in intervertebral spaces, and 19 patients in prevertebral soft tissues. Five patients with back pain got partial remission. Four patients experienced burning sensation in the lower extremity 5 minutes after bone cement filling and were relieved 10 minutes later. No severe adverse events were observed, including spinal cord compression, epidural hematoma, pulmonary infection, pulmonary embolism, bedsores, and cerebrovascular accident. After operation, improvements were observed in ODI [(31.73±7.98)% vs. (75.40±8.17)%] and VAS [(2.33±0.91)points vs. (7.23 ±0.88) points] (P<0.05). Conclusion PVP with high-viscosity bone cement can significantly relieve pain and improve motor function and hence is effective in the treatment of patients with severe OVCF. Key words: Osteoporotic fractures; Vertebroplasty; Complications