|Отделение костной патологии|
International Congress of the European Association of Tissue Banks (october 13-16, 2004, Prague), p.49.
APPLICATION OF DEMINERALIZED ALLOGRAFTS "PERFOOST" FOR REPLACING POST-RESECTIONAL BONE DEFECTS OF PATIENTS WITH TUMORS AND TUMOR-LIKE DESEASES
A.V.Balberkin, S.S.Rodionova, Yu.V.Buklemeshev, M.G.Vasiliev, M.V.Lekishvili
(Tissue Bank, Central Institute of Traumatology and Orthopaedics. Moscow, Russia).
The replacement of bone tissue defects remaining after removing tumors and tumor-like formations is a series problem now. From 2001 to may 2004 bone allografts "Perfoost" of different demineralization degree have been used in CITO clinic of bone pathology. Pre-clinic tests show that this plastic material meets all safety requirements and possesses properties accelerating bone tissue regeneration.
Methods: "Perfoost" was applied for bone plastics after bone tumor resection of 76 patients (men - 31, women - 45) aging 16-87. Localization of pathological processes was as follows: shin bone - 31, crural bone - 23, spoke bone - 14, radius - 1, peroneal bone - 1.
The reasons for surgery and plastics of bone tissue defects through "Perfoost" were the following: giant cell tumor - 15, fibroid dysplasia - 13, aneurismal bone cyst - 11, solitarian bone cyst - 9, chondroma - 8, chondrosarcoma - 5, other diseases - 13.
Only "Perfost" was applied in 53 cases but treatment of 15 patients was carried through combining "Perfoost" with biocompositional material "Osteomatris" because of specific reasons and peculiarities of every case. In 6 cases "Perfoost" was combined with frozen cortical allografts known for their strength and in 4 cases with "Collapan" containing broad spectrum antibiotics. There was 1 case of combination with denineralized bone matrix and 1 with bone autoplastics.
Results: Monitoring time was from 1,5 to 3 years. X-ray control was made in 2-3 months, 6 months, 1 year, 2 and 3 years after operation. In most cases the first signs of demineralized allograft rearrangement were discovered 2-3 months after the operation. Unlike previously applied frozen cortical allofrafts "Perfoost" produced evident and even complete replacement of defects by a newly formed bone within 1-3 years.
Undesirable effects: 2 cases of tumor relapsing after the surgery combined with "Perfoost" plastics. 5 cases of aseptic inflammation in early pos-operational period which were ceased within 14 days after the operation.
Complications: 1 case of suppuration in the post-operational period ceased through conservative treatment without revision of the previous operation zone. 3 cases (4%) of pathological fractures in the post-operational period which were caused on the one hand by insufficient mechanical strength of demineralized bone allografts and on the other hand by absence of necessary immobilization or failure to follow orthopedic regimen on the part of the patient. So afterwards while making vast edge resections which may cause the risk of pathological fracture, "Perfoost" was combined with either frozen cortical allografts or metalloosteosynthesis.
Conclusion: Assessment of clinical application of "Perfoost" proves its high plastic properties and mechanical strength. This lead to its wide application for adult patients having wide spectrum of bone pathologies.
Patient S. Solitary bone cyst.