Efficacy of cerament in large defects created by giant cell tumor
Journal Title: Journal of Bone and Joint Diseases - Year 2018, Vol 0, Issue 0
Abstract
Background: Giant cell tumors are an aggressive and potentially malignant lesion that is commonly treated by surgery involving bone grafts or synthetic bone void fillers. Although synthetic bone grafts may provide early mechanical support while minimizing the risk of donor-site morbidity and disease transmission, difficult manipulation and less than optimal transformation to bone have limited their use. Materials and Methods: In a prospective series, 14 patients of giant cell tumour with a mean age of 25 years (20–30 years range) were treated by extended curettage followed by the use of a biphasic (composed of two components 60% weight synthetic calcium sulfate and 40% weight hydroxyapatite powder) and injectable ceramic bone substitute (CEMENT™ BONE VOID FILLER, BoneSupport, Sweden). The most common location was proximal tibia (n = 6), followed by distal end of femur (n = 5), distal end humerus (n = 2), and distal end of radius (n = 1). Patients were followed clinically and radiologically for 6 months. Serial X-rays were performed thereafter to look for recurrence and bone remodeling of the bone substitute. All lower limb patients were allowed partial weight bearing immediately after surgery. All upper limb patients were allowed the active gentle range of movement exercises after surgery. Results: Lesion started bone remodeling by 2–3 months. After 6 months, the defects completely demonstrated full resolution. A serous discharge, probably response to cerament, was noted in all patients postoperatively that resolved within 2–3 weeks spontaneously. No lesions required revision surgery during the observation period. No post-operative fracture or infection was recorded. Conclusions: Extended curettage followed by high-speed cuing bur and cavity lavage with appropriate irrigants primary to the use of biphasic and injectable ceramic bone substitute might offer an alternative to regular bone graing due to convenient handling properties and rapid bone remodeling.
Authors and Affiliations
Rizwan Khan, Javed Jameel
Keywords
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