title: Ultraporous β-tricalcium phosphate alone or combined with bone marrow aspirate for benign cavitary lesions: comparison in a prospective randomized clinical trial.
abstract: BACKGROUND
  Ultraporous β-tricalcium phosphate (TCP) synthetic graft material (Vitoss; Orthovita) persists for a year or longer in some cases. In this study, we prospectively examined healing of cavitary defects filled with TCP versus TCP and bone marrow aspirate (TCP/BM) with the hypothesis that bone-marrow aspirate speeds incorporation of bone graft substitute.
  
  
  METHODS
  Fifty-five patients with a benign bone lesion undergoing surgical curettage were randomized to receive TCP (N = 26; mean duration of follow-up [and standard deviation], 20.2 ± 7.2 months) or TCP/BM (N = 29; mean duration of follow-up, 18.0 ± 7.7 months). There were no significant differences between the groups with regard to demographic or defect parameters. Clinical and radiographic evaluations were done at 1.5, three, six, twelve, eighteen, and twenty-four months, and computed tomography [CT] scans were performed at twelve months. An independent radiographic review was done to evaluate six parameters.
  
  
  RESULTS
  There was a significant (p < 0.001) increase in trabeculation through the defect and graft resorption with decreases in the persistence of the graft in both soft tissue and the defect as well as a decreased radiolucent rim around the graft over time. No significant differences were observed between the TCP and TCP/BM groups in terms of any radiographic parameter. No complications related to the graft material or BM were identified.
  
  
  CONCLUSIONS
  While significant improvements in radiographic parameters were observed in both TCP groups over two years of follow-up, the addition of BM was not found to provide any significant benefit. Results should not be extrapolated to other bone graft substitutes used for this purpose.
authors: Department of Orthopedic Surgery, SUNY Upstate Medical University, 6620 Fly Road, East Syracuse, NY 13057, USA. damront@upstate.edu
authors: Timothy A
authors: TA
authors: Damron
authors: Jennifer
authors: J
authors: Lisle
authors: Tina
authors: T
authors: Craig
authors: Michael
authors: M
authors: Wade
authors: Walter
authors: W
authors: Silbert
authors: Hal
authors: H
authors: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001847:Bone Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D016026:Bone Marrow Transplantation; D018786:Bone Substitutes / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003475:Curettage; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016062:Porosity; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
chemical_list: D001672:Biocompatible Materials; D018786:Bone Substitutes; D002130:Calcium Phosphates; C485817:beta-tricalcium phosphate