多孔生物陶瓷人工骨修复儿童良性骨肿瘤刮除术后骨缺损

Clinical performance of a porous bioceramic artificial bone in the reconstruction of bone defect after benign bone tumor curettage in pediatric patient

目的回顾分析多孔生物陶瓷人工骨填充儿童良性骨肿瘤刮除术后骨缺损的临床表现。方法 2012年1月至2015年1月对29例良性骨肿瘤患儿采用病灶刮除,多孔生物陶瓷人工骨修复骨缺损,22例患者随访资料完整。骨缺损大小0.12~47.58 cm^3。采用临床和影像学结合的方式评估人工骨降解、骨愈合等情况。结果随访1~4年,除1例单纯骨囊肿复发,避免肢体持重外,其余患儿术后未发生并发症,均在3个月内恢复日常生活及娱乐活动。术后1年X片可见材料降解及松质骨化,随时间延长呈向心性模式,松质骨化速度滞后于降解。11例在4年内完全降解。10例可见骨皮质增厚现象。结论多孔生物陶瓷人工骨可安全、有效填充青少年良性骨肿瘤术后骨缺损。

Objective To evaluate clinical performance of a porous bioceramic artificial bone in the reconstruction of bone defect after benign bone tumor curettage in pediatric patient. Methods A prospective study of the porous bioceramic artificial bone used in benign bone tumor surgery in 29 patients during 2012-2015 was conducted. Twenty-two cases were obtained complete records during the follow-up. The defect volume ranged from 0.12～47.58 cm3. Curettage and filling of the defect with porous bioceramic artificial bone was performed. Patients were followed-up clinically and radiographically. The degradation of the material and bone healing processwere assessed. Results During the follow-up period, which ranged from 1 year to 4 years, all patients were allowed to return to activities of daily living and recreational activities within 3 months after surgery without complication, except 1 patient with recurrence of simple bone cyst. Material degradation and trabeculation were visible 1 year after surgery and increased steadily over time in a centripetal fashion, however, trabeculation lagging behind degradation. Total degradation was observed in 11 patients within 4 years after surgery. Additional increased cortical thickness was also shown radiologically in 10 patients. Conclusion Porous bioceramic artifical bone is a safe and effective bone substitute for the reconstruction of bone defect after benign bone tumor curettage in pediatric patient.