Treatment alternatives and clinical outcomes of bone filling after benign tumour curettage. A systematic review

Gava, Nelson Fabrício; Engel, Edgard Eduard

doi:10.1016/j.otsr.2021.102966

Cited by 16 publications

(15 citation statements)

References 39 publications

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“…Despite the controversy, bovine bone graft has excellent applicability in surgical practice due to its availability, acceptable incorporation rate and time, lower cost than synthetic substitutes, and long storage time [ 24 ]. Our results were similar to those of previous papers using different sources of bone grafts for bone cavities secondary to curettage [ 16 , 17 , 25 ]. According to our findings, the highest percentage of cavity filling showed a trend toward better bone graft incorporation and healing.…”

Section: Discussionsupporting

confidence: 92%

“…Applying bone substitutes after curettage has shown lower rates of postoperative fractures than unfilled cavities [ 17 ]. Curettage allows the bone to slowly regain its original strength, and the substitute, according to its intrinsic characteristics, provides stiffness and accelerates healing.…”

Section: Discussionmentioning

confidence: 99%

“…Curettage allows the bone to slowly regain its original strength, and the substitute, according to its intrinsic characteristics, provides stiffness and accelerates healing. In a systematic review of 2555 patients, Gava et al [ 17 ] found that the fracture prevalence after curettage was 6.6% in unfilled cavities, 2.1% after allograft, 2.0% after bone substitutes, 1.7% after autograft, and 0% after xenograft. Although the results favored cavity filling, there was no statistical correlation between graft type and healing time [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

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Bovine Grafting: An Effective Alternative after Curettage of Benign Bone Tumors

Montanhini

Antunes

Pestilho³

et al. 2023

Life

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We retrospectively reviewed 28 patients (15 women and 13 men) with benign bone tumors or pseudotumors treated with curettage and filling with freeze-dried bovine bone graft Orthogen (Baumer S/A, São Paulo, Brazil). The aim of the study was to evaluate the rate of incorporation of Orthogen into the host bone, as well as to describe the outcomes of bone healing (quality, time, and complications). General characteristics, tumor volume, size, site, complications, percent filled, and healing quality at 6 and 12 months were assessed through radiographs. Mean patient age was 20.5 (range 4.7–75.1) years. The most common lesion type was simple bone cyst (12/28), and the most common sites were the tibia (7/28) and humerus (7/28). There were no postoperative pathologic fractures. Two cases (7.1%) of serous fluid leakage through the wound occurred. Mean cavity volume was 20.1 (range 2.7–101.4) cm3. At 6 and 12 months, 75% and 77.8% of cavities, respectively, showed complete bone healing. At 12 months, 81% of cavities filled >90% with graft showed complete bone healing vs. only 19% of those filled <90%. Filling with bovine bone graft resulted in few complications and excellent healing after curettage of benign bone tumors or pseudotumors. Complete healing occurred in most cases by 12 months. Cavities with a higher percentage of filling had a higher rate of complete radiographic incorporation.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Bovine Grafting: An Effective Alternative after Curettage of Benign Bone Tumors

Montanhini

Antunes

Pestilho³

et al. 2023

Life

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“…Although the average consolidation time after curettage of bone lesions in humans is reported to be between 3 and 4 months, regardless of whether cavities are filled, a higher fracture rate in patients with unfilled cavities could be demonstrated 29 . Similar consolidation times after grafting have been discussed in horses 20,28 .…”

Section: Discussionmentioning

confidence: 87%

Maternal allogeneic cancellous bone graft for the treatment of osteitis along the physeal scar of the proximal metatarsus in a foal

2022

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Objective: To describe the treatment and outcome of a foal with a fresh allogenic cancellous bone graft after surgical debridement of a traumatic septic osteitis.Animal: A neonatal Quarter Horse foal. Study design: Case report. Methods:The foal sustained a traumatic laceration exposing the proximal third metatarsal bone. One week after surgical debridement and closure, radiographic signs of septic osteitis were noted along the physeal scar. The lesion was debrided, and antimicrobial therapy was implemented. The infection resolved but left a large defect in the metaphysis and epiphysis. Grafting was indicated to avoid pathologic fractures of the plantar and proximal cortices.Due to a discrepancy between defect size and the bone stock of the foal, an allogeneic cancellous bone graft was harvested from the dam's tuber coxae and used to fill the foal's defect. Results: No adverse reactions to the graft were noted. After 1 month, the wound had healed. Radiographic examination was consistent with graft incorporation in the bone structure. The foal was sound at a walk and trot when examined at 6, 12, and 21 months. The bone's contour was even and its structure homogeneously radio dense. The surgical site of the mare healed without complications. Conclusion: Fresh allogenic cancellous bone grafting resulted in the healing of a large traumatic-septic bone defect in a foal, with an excellent functional and cosmetic outcome. For future use, compatibility testing should be considered prior to allogeneic bone grafting.

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“…They analyzed 12 patients treated by a single surgeon and recommended preventive osteosynthesis after curettage in case of very large lesions (> 5 cm, > 60 ccm) or high functional requirements, in obese patients and always, when local adjuvants such as ABGS were used. Moreover, studies showed that leaving the cavity un lled involves an even higher risk of postoperative fracture and that the use of bone cement for lling yields the second highest fracture risk 20,23,24 .…”

Section: Discussionmentioning

confidence: 99%

Artificial bone graft substitutes for curettage of benign and low-grade malignant bone tumors: clinical and radiological experience with Cerasorb

Wittig

Friesenbichler

Liegl‐Atzwanger

et al. 2022

Preprint

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Artificial bone graft substitutes (ABGS) for curettage of bone tumors are becoming increasingly popular. The aim of this retrospective analysis was to determine the efficacy of the ABGS Cerasorb (Curasan-AG, Kleinostheim, Germany), a beta-tricalcium phosphate (beta-TCP), concerning resorption profile, bone healing and remodeling after surgery and to evaluate potential complications. 43 patients suffering from benign and low-grade malignant bone tumors were treated with curettage and refilling of the bony cavity using the ABGS Cerasorb between 2018 and 2021 and included in the final analysis. Clinical follow-up exams with x-rays in two planes were performed six weeks, three months, six months and one year after surgery. After a mean follow-up period of 14.6 months, radiological consolidation following curettage was observed in all patients. Total resorption was observed in 16.3% of patients; in the other 83.7%, resorption was partial. In four patients, of whom two had a tumor in the distal femur and two in the humeral diaphysis, fractures occurred within six weeks after primary surgery. In conclusion, the beta-TCP Cerasorb seems to be a reliable bone graft substitute with low complication rates and is a suitable alternative to autologous bone grafts or allografts. Nonetheless, it shows a tendency of delayed resorption.

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Treatment alternatives and clinical outcomes of bone filling after benign tumour curettage. A systematic review

Cited by 16 publications

References 39 publications

Bovine Grafting: An Effective Alternative after Curettage of Benign Bone Tumors

Bovine Grafting: An Effective Alternative after Curettage of Benign Bone Tumors

Maternal allogeneic cancellous bone graft for the treatment of osteitis along the physeal scar of the proximal metatarsus in a foal

Artificial bone graft substitutes for curettage of benign and low-grade malignant bone tumors: clinical and radiological experience with Cerasorb

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