Use of a calcium sulfate-calcium phosphate synthetic bone graft composite in the surgical management of primary bone tumors

• Published in: Orthopedics (Thorofare, N.J.) Vol. 36; no. 2; pp. e216 - e222
• Main Authors: Evaniew, Nathan, Tan, Victoria, Parasu, Naveen, Jurriaans, Erik, Finlay, Karen, Deheshi, Benjamin, Ghert, Michelle
• Format: Journal Article
• Language: English
• Published: United States SLACK INCORPORATED 01-02-2013
• Subjects: Activities of daily living; Adolescent; Adult; Bone Neoplasms - surgery; Bone Substitutes; Bone Transplantation; Calcium Phosphates; Calcium Sulfate; Curettage; Cysts; Disease transmission; Ethics; Female; Humans; Male; Middle Aged; Morbidity; Patients; Reconstructive Surgical Procedures; Retrospective Studies; Tumors; Young Adult
• ISSN: 0147-7447; 1938-2367
• DOI: 10.3928/01477447-20130122-25

Benign primary bone tumors are commonly treated with intralesional curettage with or without the use of surgical adjuvants. The reconstructive approach to the resulting contained bone defects is controversial, and clinical practice is varied. Synthetic bone substitutes may provide early mechanical support while minimizing the risks of disease transmission, nonunion, infection, and donor-site morbidity. Limited data exists regarding the use of calcium sulfate-calcium phosphate composite bone substitute for this purpose. The authors retrospectively reviewed the clinical outcomes of 24 patients with benign primary bone tumors who underwent intralesional curettage followed by reconstruction with a calcium sulfate-calcium phosphate composite bone substitute. Mean follow-up was 23 months. The most common diagnosis was giant cell tumor of bone. Six patients had upper-extremity tumors and 18 had lower-extremity tumors. Mean preoperative radiographic tumor volume was 41.0 cm(3). Mean volume of PRO-DENSE (Wright Medical Technology, Arlington, Tennessee) used in each patient was 15.6 cm(3). Mean time to full weight bearing for all patients was 7.3 weeks. Two patients sustained local tumor recurrences. No postoperative fractures occurred, and no complications occurred related to the use of the calcium sulfate-calcium phosphate composite. One case of deep infection occurred secondary to wound breakdown. The use of a calcium sulfate-calcium phosphate composite was associated with rapid biological integration and an early return to activities of daily living, with no composite-related complications. This technique is a viable option in the reconstruction of cavitary bone defects following intralesional curettage of primary benign bone tumors.