Repairing Bone Defects Of Benign Bone Neoplasms And Tumor-Like Legions With Calcium Phosphate Cement

Objective: To study clinical applications of the calcium phosphate cement (CPC) on repairing bone defects of benign bone neoplasms and tumor-like legions.Methods: The CPC was implanted to repair 33 bone defects of benign bone neoplasm and tumor-like legion for 32 patients, the average age was 38 years. There were fibrous dysplasia 10 cases, giant cell tumor of bone 7 cases, bone cyst 6 cases, aneurysmal bone cyst 6 cases, chondromyxoid fibroma 1 case, non-ossifying fibroma 1 case, osteoblastoma 1 case. Positions of bone defects were 33, included femur (19), tibia (12), humerus (2). CPC have two types: grain type and powder type. We used powder type and mixture of two types. We performed intracapsular curettages for benign giant cell tumor of bone and bone cyst. After curettage, intracapsular microwave heliotherapy was performed. We only performed intracapsular curettages for the other bone neoplasm, and then, the CPC was put into bone defects. We put the MTX into the CPC in 8 cases of giant cell tumor of bone and osteoblastoma. The muscle flap of medial or lateral head of gastrocnemius was grafted to covered anterior surface of tibia in four cases of giant cell tumor of bone of proximal tibia. We observed the CPC intraoperative setting time, the postoperative systemic and local reactions, the fluctuations of serum calcium and phosphate and function of liver and kidney on the first day and fourteenth day after operation, and postoperative x-ray examination. Thefollow-up averaged 14 months (average from 6 to 30months).Results: The CPC intraoperative setting time was 15-30 minute. There were incision redness, swelling and fluid in 2 case of giant cell tumor of bone (there was MTX in CPC). All wounds healed through dressing changes. The liver function test became abnormal temporarily in 1 case (there was also MTX in CPC), and then, became normal without any therapy. Neither adverse reaction nor fluctuations of serum calcium and phosphate were found. The radiological examination showed that the bone defects was successfully restored. The follow-up showed the CPC was resolving and replacing by bone in all cases. After 3-6 months, the X-ray examination showed: the CPC margin became unclear, it's volume decreased, which showed degradation of CPC and start of substitution with bone. After 7 months to 2 years, the CPC was almost absorbed, and replaced by bone completely.Conclusion: CPC implantation after curettage of benign bone neoplasm and tumor-like legion could repair irregular bone defects completely, recovered bone intensity immediately. After replacing of bone, the repairing of bone would complete really. It is an easy method to repair bone defects with few complications.