Integration of porous hydroxylapatite ceramic prosthesis at the distal radius in elderly patients. Radiological examination

Abstract

Between April 1994 and December 1995 14 patients (average age 56 (41-71) years, 13 women, one man) suffering from a fracture of the distal radius (Extensionsfracture, type 1B by Pechlaner, AO-classification A2 and A3) were treated by minimal invasiv procedure. The bone defect was substituted with hydroxylapatit ceramic. In a prospective study the osteointegration of the alloplastic bone graft was evaluated radiographically and on MRI. Up to week 12 X-ray revealed a radiolucenty around the allograft in all patients. After 6 months trabecular structure reached the alloplastic bone graft in 57% of the patients. After one year the surface of the hydroxylapatit ceramic was remodelled in 36% of the patients. At this time MRI examination with contrast agent demonstrated marginal integration of the alloplastic bone craft in 71%. X-ray follow up showed stageable integration of the porous hydroxylapatit ceramic. MRI examination demonstrated partial osteointegration. Hydroxylapatit ceramic was incorporated in radial metaphyse of elder patients without any complications.

Cancellous Allograft versus Autologous Bone Grafting For Repair of Comminuted Distal Radius Fractures: A Prospective, Randomized Trial

“…Other bone graft substitutes such as injectable bone cements, synthetic ceramics and hydroxyapatite-chips are increasingly investigated, the lack of comparing prospective studies and the high material costs, however, don't support a routine application so far. 20,21,22 As we showed, iliac crest bone graft harvesting is accompanied by significant morbidity. This point generally is underestimated because treatment is focused on the treatment of the radius fracture.…”