Nano-hydroxyapatite/polyamide 66 composite filling combined with locking plate in the treatment of fibrous dysplasia of femoral bone / 中国组织工程研究

ABSTRACT

BACKGROUND: Nano-hydroxyapatite/polyamide 66 composite (n-HA/PA66) has good biocompatibility, osteoinduction, osteoconductivity and osteogenesis. It is widely used in clinical fracture healing, spinal fusion, and other bone repair. OBJECTIVE: To observe the effect of n-HA/PA66 filling combined with locking plate in the treatment of fibrous dysplasia of femoral bone. METHODS: From May 2015 to May 2018, 15 patients with fibrous dysplasia of bone were admitted to Xingtai People’s Hospital Affiliated to Hebei Medical University. There were 4 males and 11 females, aged 16-58 years. The lesions were all located in the femur. They were all treated with n-HA/PA66 filling combined with locking plate. The patients were followed up for 18-40 months. Imaging examination (X-ray and CT scan) was carried out to evaluate the bone healing. Musculoskeletal Tumor Society (MSTS) score and Harris score were used to assess the functional recovery of patients after operation. RESULTS AND CONCLUSION: (1) X-ray films showed that there was a clear boundary between the transplanted bone and the host bone immediately after the operation. At 3 months after the operation, the transplanted bone was replaced partly by crawling. At 6 months, new bone formation was obvious. At 9-12 months, new bone formed completely. The transplanted bone was basically catabolized. At 18 months, the new bone was completely integrated with the host bone. The boundary between the new bone and the host bone disappeared. New bone and host bone are connected by direct trabecula. (2) At the last follow-up, CT images showed that the local lesions were eliminated; no recurrence or metastasis occurred; and the grafts healed completely. The G/N ratio was 0.78±0.09. (3) At the last follow-up, 15 patients’ pain all disappeared, MSTS score was 28.1±0.7. Harris score was 94.3. Daily physical activity was restored. (4) n-HA/PA66 composite material has obvious osteogenic effect on the bone defect caused by the removal of fibrous dysplasia. Locking plate fixation can make patients move early and obtain good postoperative function.