Allogeneic bone for repairing bone defects after resection of benign bone tumor and tumor-like lesions

Yanfei JIA; Shibing GUO; Wei FENG

ABSTRACT

BACKGROUND:

Bone defects forming after resection of bone tumor and tumor-like lesion are often packed with autogeneic bone. But sample amount cannot completely meet the clinical demand and different degrees of complications are often left in the bone graft donor region. All these problems remarkably limit the application of autogeneic bone. Allogenic bone is increasingly widely used in the clinical practice due to its structure and biological characteristics similar to autogeneic bone, rich sources, long-term preservation, easy to use and other advantages.

OBJECTIVE:

To investigate the biocompatibility and clinical application effects of allogeneic bone in filling and repairing benign bone tumor and tumor-like lesion after resection and curettage.

DESIGN:

A retrospective analysis.

SETTING:

Department of Pelvis Surgery, Second Affiliated Hospital of Inner Mongolia Medical College.

PARTICIPANTS:

Totally 230 patients (156 males and 74 females, with age of 5-56 years) were admitted to Department of Bone Tumor, Second Affiliated Hospital of Inner Mongolia Medical College from December 1999 to December 2005 to undergo curettage and hyperthermia inactivation due to benign bone tumor and tumor-like lesion and to receive the treatment by filling and repairing bone defects with lyophilized small-segment allogeneic bone, and were recruited for this study. Written informed consents of treatment were obtained from all the patients. The protocol was approved by the Hospital's Ethics Committee.

METHODS:

Allogeneic bone grafts (Shanxi Aorui Biomedical Co.,Ltd /Shanxi Provincial Medical Tissue Banking) were used to fill and repair bone defects. Patients who had benign bone tumor, bone cyst or osteofibrous dysplasia underwent cyst curretage. Allogeneic bones were used to pack empty cavity. Therapeutic effects were assessed according to the scoring criteria of allogeneic bone transplantation from Mankin et al, consisting of satisfactory and unsatisfactory two levels. X-ray plain films of surgery sites were taken at postoperative 3, 6 and 12 months. The patients were followed up for 38 months on average in order to observe the therapeutic effects. MAIN OUTCOME

MEASURES:

Histocompatibility of allogeneic bone in filling and repairing bone tumor defects.

RESULTS:

All 230 patients participated in the final analysis. ① Biocompatibility of allogeneic bone Postoperatively, minority of patients had mild immunological rejections. Such allogeneic bone grafts had a good biocompatibility. They could directly fuse with bone tissue in the implantation location of patients, but not inhibit the normal activity of osteocytes on the allogeneic bone grafts or interfere the natural substitution of autogeneic osteocytes, i.e. there were no or less immunological rejections. Bone union was obtained in all the patients at postoperative 6-18 months (6.5 months on average). Thirty-four patients presented exudation of light yellow liquid from incision. Incisions healed in 30 (14.8%) patients at postoperative 2 weeks and in 4 (1.7%) in later time. Altogether 196 (85.2%) patients obtained satisfactory therapeutic effects, but 34 (14.8%) obtained unsatisfactory therapeutic effects.

CONCLUSION:

Small-segment allogeneic bones have good histocompatibility and osteogenesis, and they are good bone grafts in the bone transplantation.