[Repairing bone defects of benign bone neoplasm by grafting of bioactive glass combined with autologous bone marrow].
OBJECTIVE
To investigate the clinical application of grafting with bioactive glass (BG) and autologous bone marrow for defect after resection and curettage of benign bone neoplasm.


METHODS
From January 2004 to May 2007, 34 patients with bone defects were repaired. There were 21 males and 13 females with a mean age of 25.6 years (8 to 56 years). There were 14 cases of simple bone cysts, 6 cases of fibrous dysplasia, 3 cases of osteoid osteoma, 4 cases of non-ossifying fibroma, 2 cases of enchondroma and 3 cases of giant cell tumor of bone. Tumor sizes varied from 2.0 cm x 1.5 cm x 1.0 cm to 9.0 cm x 3.0 cm x 2.5 cm. Benign bone neoplasm was removed thoroughly with a curet or osteotome, bone defects ranged from 3.0 cm x 2.0 cm x 1.5 cm to 11.0 cm x 3.5 cm x 3.0 cm, which was closed-up with the mixtures of BG and autogenous red bone marrow. Six cases of pathologic fracture were fixed with steel plate or intramedullary nail. The postoperative systemic and local reactions were observed, and the regular X-ray examinations were performed to observe the bone healing.


RESULTS
All the patients had good wound healing after operation. There was no yellow effusion nor white crystal and skin rash appeared around wound, indicating no allergic reaction occurred. A follow-up of 1 to 4 years (mean 24.6 months) showed satisfactory healing without complications. At averaged 16 weeks after operation, patients with bone tumor in lower limbs resumed walking independently and those with bone tumor in upper limbs resumed holding object. There was no tumor recurrence during follow-up. Radiographically, the interface between the implanted bone and host bone became fuzzy 1 month after implantation. Two months after operation, the BG was absorbed gradually, new bone formation could be seen in the defects. Four months after operation, implanted bone and host bone merged together, bone density increased. Six to ten months after operation, the majority of the implanted BG was absorbed and substituted for new bone, bone remodeling was established.


CONCLUSIONS
BG may boast both bone conductive and bone inductive activities. The combined grafting with BG and autologous bone marrow appears to be minimally invasive treatment to repair bone defects of benign bone neoplasm, with rare complications and no significant reverse reaction, and could repair bone defects completely.
Liu
Hongwei
H
Department of Orthopedics, First Hospital Affiliated to Suzhou University, Suzhou Jiangsu 215006, PR China.
Sun
Junying
J
Wang
Yong
Y
Yang
Xing
X
Zhu
Ershan
E
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D001859:Bone Neoplasms / Q000601:surgery; D018786:Bone Substitutes; D001842:Bone and Bones / Q000473:pathology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005898:Glass; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D014182:Transplantation, Autologous
D018786:Bone Substitutes