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Abstract
Purpose
This study was performed to evaluate the efficiency of demineralized bone matrix (DBM, Genesis®) used for bone defect after operative traetment of benign bone tumors by clinical and radiological methods.
Materials and Methods
DBM was used to treat bone defect after operative treatment of benign tumor from February 2012 to May 2013. Total 25 benign bone tumor cases (15 males, and 10 females) with mean age of 30.3 were studied. The diagnoses were solitary bone cyst in 9 cases, non ossifying fibroma in 5, fibrous dysplasia in 5, aneurysmal bone cyst in 3 and enchondroma in 3. In categorization by location of tumor, there were 5 cases of distal femur, 4 of proximal tibia, 3 of proximal femur, 3 of proximal humerus, 3 of phalanx, 2 of distal radius, 2 of hip bone, 2 of calcaneus, and 1 of scapula. Autogenous bone was used with DBM in 6 cases, and only DBM used in 19 cases. Mean periods of follow up were 8.7 months (range: 6 to 14 months). Amount of graft resorption and bone formation was observed with compare of post operation radiograph and the difference was shown by percentage. Resorption level was measured by DBM level which could be observed from simple x-ray, and bone formation level by bone trabecular formation level at impaired site.
Results
Twenty three cases of total 25 cases showed bone union. In the 23 cases, more than 98% DBM resorption was observed after mean 4.3 months, and more than 98% bone formation was observed after mean 6.9 months. Lesser bone defect sizes showed faster bone formation and it was statistically significant (p=0.036). But other comparative studies on other factors such as, sex, age of patients and combination of autogenous bone were no statistically significant differences in graft resorption and bone formation. And there was no significant complication in periods of follow-up.
References
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Figure 2.
Solitary bone cyst of Proximal Humerus in a 12-year-old patient. (A) Humerus anteroposterior radiograph shows osteolytic bone lesion on proximal humerus area. (B) Immediate postoperative radiograph shows plate fixation and DBM implantation. (C, D) At 6 months, AP & Lateral radiographs after operation show complete bone union.
Figure 3.
Aneurysmal bone cyst of Distal Femur in a 51-year-old patient. (A) Initial radiograph shows osteolytic lesion of distal femur. (B) Immediate postoperative radiograph shows Autobone graft and DBM implantation. (C, D) At 13 months, AP & Lateral radiographs after operation show incomplete bone union.
Table 1.
Types of Bone Tumor
| No. of case | (%) | |
|---|---|---|
| SBC | 9 | 36 |
| NOF | 5 | 20 |
| FD | 5 | 20 |
| ABC | 3 | 12 |
| Enchondroma | 3 | 12 |
| Total | 25 | 100 |
Table 2.
Anatomical Location of the Bone Defect
| Site | No. of case | (%) |
|---|---|---|
| Dist femur | 5 | 20 |
| Prox tibia | 4 | 16 |
| Prox femur | 3 | 12 |
| Humerus | 3 | 12 |
| Hand | 3 | 12 |
| Dist radius | 2 | 8 |
| Pelvis | 2 | 8 |
| Calcaneous | 2 | 8 |
| Scapula | 1 | 4 |
| Total | 25 | 100 |
Table 3.
Demographic Data of the Patients (N=25)
Table 4.
Time for Graft Resorption and Bone Formation
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