Christiane Sylvia Leibold, Andreas Hecker, Florian Schmaranzer, Klaus Arno Siebenrock
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引用次数: 0
Abstract
Introduction
Bone wax is a haemostatic agent, widely used to prevent bleeding from bone surfaces. Despite its effectiveness in haemostatic control, it can lead to foreign body granuloma and osteolysis. Therefore, the aim of this study was to assess the rate and progress of osteolysis after surgical bone wax application.
Methods
We included 425 patients between 01/2002 and 12/2006 that underwent offset correction for cam type femoroacetabular impingement with application of bone wax for homogeneous statistical cohort formation. Comparison was made to a similar cohort group undergoing offset correction without application of bone wax, including 479 patients between 01/2008 and 12/2012. Out of the study group, six hips in five patients presented with persisting pain and growing osteolysis on the X-rays in the area of the offset correction, and two underwent subsequent revision surgery. None of the patients in the cohort group presented with osteolysis. In both groups, patients who presented with persisting pain without radiological osteolysis had other determinable causes as labral tears, progressing osteoarthritis, trochanteric bursitis, and adhesions as suggested source of the pain. We measured the relative area of the osteolysis where present (area of osteolysis/area of femoral head in %) on lateral radiographs on the first postoperative X-rays and latest follow-up X-rays, with a mean follow-up time of 8.6 ± 2.5 years (range, 5–13 years). Histologic samples were taken at revision surgery.
Results
The relative area of osteolysis increased in all hips from a directly postoperative median of 5.5% ± 2.7% (2.3-10.7%) to 11.2% ± 3.9% (7.1-17.3%) at last follow-up. In patients undergoing revision surgery for osteolysis, remaining wax as a foreign material with attached multinucleated giant cells and abundant mononuclear cells was detected histologically.
Conclusion
The intra-articular use of bone wax should be approached with caution and with awareness of the possible complications.
期刊介绍：
"Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance.
"Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).
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