Novel fully interconnected porous hydroxyapatite ceramic in surgical treatment of benign bone tumor.
BACKGROUND
Large bone defects remaining after curettage of benign bone tumors should be filled with a substitute to restore mechanical strength. In 2000, we developed a fully interconnected porous calcium hydroxyapatite ceramic (IPCHA, NEOBONE) and have utilized it as a bone substitute. IP-CHA has a finely organized, three-dimensional interconnecting pore structure. The large interconnecting channels (average diameter 40 microm) permit easy penetration of tissue into the deep pores, so IP-CHA can itself induce local bone repair processes. The purpose of this study was to evaluate the clinical outcomes with the use of IP-CHA as bone substitute after curettage of benign bone tumors.


METHODS
We reviewed the results of 71 patients with benign bone tumors sequentially treated by curettage followed by implantation of IP-CHA between 2000 and 2006. There were 29 women and 42 men, with a mean age of 28 years. Assessment was based on radiography at each time point during the follow-up. Radiographic findings were classified into five stages: stage 0, no change; stage 1, slight bone formation; stage 2, moderate bone formation; stage 3, consolidation; stage 4, absorption.


RESULTS
In 70 of 74 operated lesions, radiographs showed that implanted IP-CHA proceeded to stage 2 or more within an average of 8 months after the surgery. In addition, 17 lesions proceeded to stage 4 within 35 months after surgery, on average. However, there were 10 local recurrences, which is similar to the recurrence rate for such tumors treated with or without implantation of CHAs and reflects the biological nature of each tumor.


CONCLUSIONS
In this study, we utilized IP-CHA as a bone substitute after curettage of benign bone tumors and demonstrated its usefulness in the clinical situation. IP-CHA comparatively exhibited excellent bone formation at an early stage although the problem of recurrence of the tumor remained. We conclude that IP-CHA is a useful bone substitute for the treatment of benign bone tumors.
Tamai
Noriyuki
N
Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Myoui
Akira
A
Kudawara
Ikuo
I
Ueda
Takafumi
T
Yoshikawa
Hideki
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000601:surgery*; D018786:Bone Substitutes / Q000627:therapeutic use; D002516:Ceramics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017886:Durapatite / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010012:Osteogenesis / Q000187:drug effects; D012189:Retrospective Studies; D055815:Young Adult
D018786:Bone Substitutes; D017886:Durapatite