Effect of Tricalcium Phosphate on Healing of Non-Unions: An Observational Study of over 400 Non-Unions.

IF 2.3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Therapeutics and Clinical Risk Management Pub Date : 2023-05-12 eCollection Date: 2023-01-01 DOI:10.2147/TCRM.S409119

Thomas Ferbert, Christina Münch, Sebastian Findeisen, William Pauly, Matthias Miska, Tobias Grossner, Michael C Tanner, Gerhard Schmidmaier, Lars Helbig

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引用次数: 0

Abstract

Purpose: A central aspect of the treatment of non-unions is the filling of bone defects. The quantity of available autologous bone for this purpose is limited. Alternatively, or additionally, bone substitutes may be used. The aim of this retrospective, single-center study including 404 non-unions in 393 patients is to investigate the effect of tricalcium phosphate (TCP) on the healing of non-unions. Furthermore, the influence of gender, age, smoking status, comorbidities, type of surgical procedure, presence of infection, and length of treatment was investigated.

Methods: We evaluated three groups of patients. Group 1 received TCP + BG, group 2 received BG alone and group 3 received no augmentation. Bone stability was assessed 1 and 2 years after non-union revision surgery through analysis of radiographs using the Lane Sandhu Score. Scores ≥3 were rated as stable Other influencing factors were collected from the electronic medical record.

Results: In 224 non-unions, bone defects were filled with autologous bone and TCP (TCP+BG). In 137 non-unions, bone defects were filled with autologous bone (BG), and in 43 non-unions presenting non-relevant defects, neither autologous bone nor TCP were used (NBG). After 2 years, 72.7% of the TCP+BG patients, 90.1% of the BG patients and 84.4% of the NBG patients achieved a consolidation score ≥3. Advanced age, presence of comorbidities and longer treatment period had a significantly negative effect on consolidation 1 year after surgery. Longer treatment periods also showed a negative significant effect after 2 years. It is notable that larger defects, mainly treated with the combination of autologous bone and TCP, showed similar healing rates to that of smaller defects after 2 years.

Conclusion: The combination of TCP and autologous bone-grafts shows good results in the reconstruction of complicated bone-defects, but patience is required since the healing period exceeds 1 year in most patients.

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磷酸三钙对非溃疡愈合的影响：对 400 多例非溃疡患者的观察研究。

目的：治疗非关节畸形的核心是填充骨缺损。可用于此目的的自体骨数量有限。此外，还可以使用骨替代物。这项回顾性单中心研究包括 393 名患者的 404 例非臼齿缺损，旨在研究磷酸三钙（TCP）对非臼齿缺损愈合的影响。此外，还调查了性别、年龄、吸烟状况、合并症、手术类型、是否感染以及治疗时间长短等因素的影响：我们对三组患者进行了评估。方法：我们对三组患者进行了评估，第一组接受 TCP + BG，第二组仅接受 BG，第三组未接受任何增量治疗。通过使用 Lane Sandhu 评分法分析 X 光片，评估非愈合翻修手术后 1 年和 2 年的骨稳定性。从电子病历中收集其他影响因素：在 224 例非关节畸形中，骨缺损由自体骨和 TCP（TCP+BG）填充。在 137 例非关节畸形中，使用自体骨填充骨缺损（BG）；在 43 例出现非相关缺损的非关节畸形中，既未使用自体骨，也未使用 TCP（NBG）。2 年后，72.7% 的 TCP+BG 患者、90.1% 的 BG 患者和 84.4% 的 NBG 患者的巩固评分≥3。高龄、合并症和较长的治疗时间对术后一年的巩固效果有明显的负面影响。治疗时间较长对术后 2 年的巩固效果也有明显的负面影响。值得注意的是，主要使用自体骨和 TCP 联合治疗的较大缺损在 2 年后的愈合率与较小缺损相似：结论：TCP 和自体骨移植的组合在复杂骨缺损的重建中显示出良好的效果，但由于大多数患者的愈合期超过 1 年，因此需要耐心等待。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-

CiteScore

4.80

自引率

3.60%

发文量

139

审稿时长

16 weeks

期刊介绍： Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.