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背景:近年来,人们开发生产了多种骨移植替代物,其中OsteoSet是一种新型骨移植替代物,具有良好的生物相容性、可降解性、骨传导性及诱导成骨活性,是一种理想的骨移植替代品,已用于骨肿瘤、创伤、感染等原因导致的骨缺损。目的:观察OsteoSet修复骨肿瘤性骨缺损的临床应用价值。设计:回顾性病例分析。单位:吉林大学第一医院骨科。对象:选择2004-06/2006-09在吉林大学第一医院骨科22例接受手术的骨肿瘤骨缺损患者,男14例,女8例,年龄5～68岁,平均23岁。纳入标准:①均符合1983年我国制定的骨肿瘤分类标准诊断为良性骨肿瘤。②具有肿瘤切除术及OsteoSet骨移植替代物进行骨移植的手术指征。③对手术项目知情同意。肿瘤位置分布如下:位于肱骨干6例,股骨颈2例,股骨下段9例,胫骨上段4例,跟骨1例。方法:①手术过程:常规方法有效麻醉,充分暴露肿瘤组织,尽量彻底切除肿瘤,当应用OsteoSet填充骨缺损时,仔细操作,避免将颗粒压碎。最后用骨膜和软组织覆盖骨移植替代物。②术后评估:于术后第4,8,12,24周X射线片检查测定骨移植替代物吸收及新骨生长情况;于术后6,7,8,9个月观察患者术后手术切口愈合、患处疼痛及并发症情况。主要观察指标:骨移植替代物吸收及新骨生长情况;术后随访结果。结果:纳入22例患者均进入结果分析。①骨移植替代物吸收率及新骨生长率:术后4周的X射线片可见OsteoSet骨移植替代物明显吸收,同时出现纤细的骨小梁结构,骨密度增加。术后第12周末,约97.1%的OsteoSet替代物被吸收,同时约95.3%的新生骨长入。术后24周,骨移植替代物吸收率和新骨生长率分别为99.1%和98.6%。骨缺损区形成稳定的骨小梁结构,通过骨重建新生骨与周围的正常骨自然结合。②随访结果:所有患者手术切口愈合良好,住院期间无患处疼痛、不适等并发症。随访期间所有患者无发热、皮疹及其他过敏反应。术后定期复查X射线片显示,OsteoSet骨移植替代品吸收良好,骨缺损区新骨形成良好。本组病例无移植物相关并发症,患者对治疗结果满意。结论:OsteoSet骨移植替代物吸收与新骨生长基本同步,是一种理想的骨缺损充填材料。
BACKGROUND: In recent years, many kinds of bone graft substitutes have been developed and produced. Among them, OsteoSet is a new bone graft substitute with good biocompatibility, biodegradability, osteoconductivity and osteogenic activity An ideal alternative to bone graft, has been used for bone defects caused by bone tumors, trauma, infections and the like. Objective: To observe the clinical value of OsteoSet in repairing bone tumor of bone. Design: retrospective case analysis. Unit: First Hospital of Jilin University orthopedics. PARTICIPANTS: Twenty - two patients with bone tumor underwent surgery from January 2004 to September 2006 in the Department of Orthopedics, the First Hospital of Jilin University. There were 14 males and 8 females, aged from 5 to 68 years, with an average of 23 years. Inclusion criteria: ① are in line with the 1983 classification of bone tumors in China developed a diagnosis of benign bone tumors. ② with tumor resection and OsteoSet replacement of bone graft for surgical indications. ③ informed consent of surgical items. Tumor location is as follows: 6 cases of humeral shaft, 2 cases of femoral neck, 9 cases of lower femur, 4 cases of upper tibia, calcaneus in 1 case. Methods: ① Surgical procedure: The conventional method was effective anesthesia, full exposure of the tumor tissue, tumor resection as thoroughly as possible. When OsteoSet was used to fill the bone defect, careful operation was performed to avoid crushing the granules. Finally, replace the bone graft with periosteum and soft tissue. ② Postoperative evaluation: X-ray examination at 4, 8, 12, and 24 weeks postoperatively detected bone graft replacement and new bone growth; postoperative operation was observed at 6, 7, 8 and 9 months after operation Incision healing, pain and complications in the affected area. MAIN OUTCOME MEASURES: Absorption of bone substitute and growth of new bone; Follow-up results after surgery. RESULTS: Twenty-two patients were included in the result analysis. ① bone graft replacement rate and new bone growth rate: 4 weeks after the X-ray showed OsteoSet bone graft significantly absorbed, while there slender trabecular structure, increased bone mineral density. At the end of the twelfth week, about 97.1% of OsteoSet surrogates were absorbed, with about 95.3% of new bone ingrowth. At 24 weeks after operation, the rates of bone graft replacement and new bone growth were 99.1% and 98.6%, respectively. Bone defects in the formation of stable trabecular structure, through the bone remodeling of new bone with the surrounding normal bone naturally. ② follow-up results: All patients with surgical incision healed well, no pain during the hospitalization, discomfort and other complications. All patients had no fever, rash and other allergic reactions during follow-up. Regular review of X-rays postoperatively showed that OsteoSet was well absorbed by bone substitutes and that new bone formed in the defect area. The group of patients without graft-related complications, the patient satisfaction with the treatment. CONCLUSIONS: OsteoSet bone graft substitutes are basically synchronized with new bone growth and are an ideal bone defect filling material.