scholarly journals 405 Radiological Analysis of Gentamicin Eluting Synthetic Bone Graft Substitute Used in The Management of Gustilo IIIB Open Fractures

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Aljawadi ◽  
I Madhi ◽  
T Naylor ◽  
M Elmajee ◽  
A Islam ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cortical Thickness ◽  
Bone Graft Substitute ◽  
Fracture Site ◽  
Open Fractures ◽  
X Rays ◽  
Radiographic Images ◽  
Synthetic Bone ◽  
Synthetic Bone Graft

Abstract Background Management of traumatic bone void associated with Gustilo IIIB open fractures is challenging. Gentamicin eluting synthetic bone graft substitute (Cerament-G) had been recently utilised for the management of patients with these injuries. This study aims to assess radiological signs of Cerament-G remodelling. Method Retrospective data analysis of all patients admitted to our unit with IIIB open fractures who had Cerament-G applied as avoid filler. Postoperative radiographic images of the fracture site at 6-weeks, 3-months, 6-months and at the last follow-up were reviewed. The radiological signs of Cerament-G integration, percent of void healing, and bone cortical thickness at the final follow-up were assessed. Results 34 patients met our inclusion criteria, mean age: 42 years. Mean follow-up time was 20 months. 59% of patients had excellent (>90%) void filling, 26.4% of patients had 50-90% void filling, and 14.6% had < 50% void filling. Normal bone cortical thickness was restored on AP and Lateral views in 55.8% of patients. No residual Cerement-G was seen on X-rays at the final follow-up in any of the patients. Conclusions Our results showed successful integration of Cerament-G with excellent void filling and normal cortical thickness achieved in more than half of the patients.

scholarly journals Radiographic and Histological Analysis of a Synthetic Bone Graft Substitute Eluting Gentamicin in the Treatment of Chronic Osteomyelitis

2019 ◽  
Vol 4 (2) ◽  
pp. 76-84 ◽  
Author(s):  
Jamie Ferguson ◽  
Nicholas Athanasou ◽  
Michael Diefenbeck ◽  
Martin McNally
Keyword(s):  
Bone Formation ◽  
Bone Graft ◽  
Dead Space ◽  
Histological Analysis ◽  
Chronic Osteomyelitis ◽  
Bone Graft Substitute ◽  
Synthetic Bone ◽  
Synthetic Bone Graft ◽  
Infection Recurrence

Abstract. Introduction: Managing chronic osteomyelitis can be challenging and attention to the osseous dead-space left following resection is an important part of successful treatment. We assess radiographic bone healing following implantation of a gentamicin-eluting synthetic bone graft substitute (gBGS) used at chronic osteomyelitis (cOM) resection. We also describe histological carrier changes from biopsies in nine cases at various time points.Methods:This was a retrospective review of a prospectively collected consecutive series of 163 patients with Cierny-Mader Type III or IV cOM who underwent single-stage excision, insertion of gBGS and definitive soft-tissue closure or coverage. Bone defect filling was assessed radiographically using serial radiographs. Nine patients had subsequent surgery, not related to infection recurrence, allowing opportunistic biopsy between 19 days and two years after implantation.Results: Infection was eradicated in 95.7% with a single procedure. 138 patients had adequate radiographs for assessment with minimum one-year follow-up (mean 1.7 years, range 1.0-4.7 years). Mean void-filling at final follow-up was 73.8%. There was significantly higher void-filling in metaphyseal compared to diaphyseal voids (mean 79.0% versus 65.6%; p=0.017) and in cases with good initial interdigitation of the carrier (mean 77.3% versus 68.7%; p=0.021). Bone formation continued for more than two years in almost two-thirds of patients studied (24/38; 63.2%).Histology revealed active biomaterial remodelling. It was osteoconductive with osteoblast recruitment, leading to the formation of osteoid, then woven and lamellar bone on the substrate's surface. Immunohistochemistry demonstrated osteocyte specific markers, dentine matrix protein-1 and podoplanin within the newly formed bone.Conclusion: This antibiotic-loaded biomaterial is effective in managing dead-space in surgically treated cOM with a low infection recurrence rate (4.3%) and good mean bone void-filling (73.8%). The radiographic resolution of the bone defect is associated with bone formation, as supported by histological analysis.

scholarly journals Synthetic Bone Graft Substitute for Treatment of Unicameral Bone Cysts

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Carl Nunziato ◽  
John Williams ◽  
Ronald Williams
Keyword(s):  
Bone Graft ◽  
Bone Graft Substitute ◽  
Bone Cysts ◽  
Synthetic Bone ◽  
Synthetic Bone Graft

scholarly journals Establishment and effects of allograft and synthetic bone graft substitute treatment of a critical size metaphyseal bone defect model in the sheep femur

Apmis ◽  
2019 ◽  
Vol 127 (2) ◽  
pp. 53-63 ◽  
Author(s):  
Werner Hettwer ◽  
Peter F. Horstmann ◽  
Sabine Bischoff ◽  
Daniel Güllmar ◽  
Jürgen R. Reichenbach ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Defect ◽  
Critical Size ◽  
Bone Graft Substitute ◽  
Defect Model ◽  
Synthetic Bone ◽  
Synthetic Bone Graft ◽  
Metaphyseal Bone

Chronology of the Radiographic Appearances of the Calcium Sulfate-Calcium Phosphate Synthetic Bone Graft Composite following Resection of Bone Tumors: A Follow-up Study of Postoperative Appearances

2016 ◽  
Vol 67 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Victoria Tan ◽  
Nathan Evaniew ◽  
Karen Finlay ◽  
Erik Jurriaans ◽  
Michelle Ghert ◽  
...  
Keyword(s):  
Calcium Phosphate ◽  
Bone Graft ◽  
Calcium Sulfate ◽  
Bone Ingrowth ◽  
Graft Material ◽  
Synthetic Graft ◽  
Synthetic Bone ◽  
Synthetic Bone Graft ◽  
Graft Resorption

Purpose The objective of the study was to characterize the radiographic appearance of graft resorption and new bone incorporation into a postresection defect of the calcium-sulfate calcium-phosphate synthetic bone graft composite following resection of benign bone tumours. Methods Twenty-five patients who underwent treatment with the CaSO4/CaPO4 synthetic graft following bone tumour resection were retrospectively identified from our oncology database. Postoperative radiographs were assessed for: 1) combined partial graft resorption and ingrowth at the graft site; 2) complete graft resorption with complete incorporation of new bone into the defect. After chronologically grouping radiographs, the volume of graft material used to fill bony defects, radiographic evidence of complications, and patterns of resorption were recorded. Results Partial resorption of graft material/partial ingrowth of new bone was seen in 21 patients at 2.5 months postoperatively. Complete resorption of graft with complete new bone incorporation at the graft site was seen in 94% of cases (15 of 16) by 10 months after surgery. Mean time to complete incorporation of new bone was 6.7 months. Time to resorption of the graft with new bone ingrowth was found to be related to the volume of graft used with smaller volumes showing earlier resorption. For all cases demonstrating resorption (21 of 21), the pattern observed was peripheral to central. Five patients developed complications, including tumour recurrence, cyst formation, and graft site infection. Conclusion Our study suggests a characteristic time and volume related radiographic pattern of resorption and new bone ingrowth with the CaSO4/CaPO4 synthetic graft. Findings that deviate from this pattern may represent complication and warrant additional follow-up.

TOBRAMYCIN ELUTION FROM BONE SUBSTITUTE

2000 ◽  
Vol 04 (02) ◽  
pp. 129-134 ◽  
Author(s):  
M. W. Lawless ◽  
R. T. Laughlin ◽  
J. M. Kerpsack ◽  
D. Pisut
Keyword(s):  
Bone Graft ◽  
Bone Graft Substitute ◽  
Test Tube ◽  
Sterile Water ◽  
Delivery Vehicle ◽  
Synthetic Bone ◽  
Synthetic Bone Graft ◽  
Autologous Grafts ◽  
Phosphate Buffered Saline ◽  
Antibiotic Level

Purpose: To determine the rate of antibiotic elution from tobramycin-impregnated ProOsteon (Interpore) and Collagraft (Zimmer). Methods: Five samples of Collagraft and ProOsteon were impregnated with a solution containing 1.2 g of tobramycin and 10 ml of sterile water. The samples were then allowed to dry overnight. These samples were stored at 37°C in separate test tubes containing phosphate buffered saline (PBS). The solution in each test tube was removed with a pipette at hours 3, 6, 9 and 12 and days 1, 2, 3, 5, 7, 9, 11 and 13. The PBS was then replaced. The pipetted solution was sent for laboratory quantification and also used in a bioassay to determine antibiotic level. To serve as a control, two additional samples of each bone graft that were not impregnated with antibiotic were placed in separate test tubes and subjected to the same protocol. Results: The antibiotic elution rate for both ProOsteon and Collagraft was high at 3 hours [5362 and 4875 μg/ml on day 3 (3.1 μg/ml) for the Collagraft and day 7 (3.7 μg/ml) for the ProOsteon]. Effective intravenous tobramycin level is considered to be 4–6 μg/ml. Conclusion: Bone graft substitute can be used as a delivery vehicle for tobramycin. In addition, antibiotic-impregnated synthetic bone graft may potentially fill a dead space or cavitary defect without the need for large autologous grafts and does not require later removal.

Sign in / Sign up

Export Citation Format

Share Document